• Title/Summary/Keyword: Abnormal Sound

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Matching Pursuit based on Frequency Characteristics of Heart Sounds for Phonocardiogram Analysis (심음 분석을 위한 주파수 특성에 기반한 매칭퍼슈잇 방법)

  • Kim, Il-Dong;Jeong, Gyu-Hyeok;Lim, Jong-Ha;Lee, In-Sung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.47 no.1
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    • pp.47-55
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    • 2010
  • Although heart auscultation is an important tool for the diagnosis of heart disease, it is seen that the human ear is poorly suited for cardiac auscultation such as the paradoxical split of S2, the split of S2, and the summation of S2 and S3 gallop. In this paper, the analysis-synthesis method that is suitable for the characteristics of PCG is proposed to classify the heart sound. In analyzing the PCG according to matching pursuit method and synthesizing the PCG in each bandwidth based on the frequency characteristics, it sorts normal hearts with abnormal hearts that is difficult to classify as cardiac auscultation. The result shows that it qualifies the appearance of split in S2 and the paradoxical split of S2 and also can estimate the delay between the two components.

A Study for the Effect of Electrical Stimulation on ABR and ECochG (전기자극이 ABR과 ECochG에 미치는 영향에 관한 연구)

  • Kim, K.S.;Park, J.W.;Im, J.J.;Moon, I.H.;Jeon, B.H.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.240-242
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    • 1996
  • Use of electrical stimulation for diagnosis and treatment of pyhsiolgocial impairment on the auditory system was reported by many researchers since 1800. Unfortunately, there were no standard methods or theoretical bakground for choosing stimulus conditions because of the lack of understanding on the transmission of sound through the auditory pathways. Therefore, if we could find the mechanisms of normal and abnormal functions for the system objectively, it may be possible to establish the conditions for the appropriate treatment This study was devised with three experimental conditions of electrical stimulation(0.1, 1, and 10mA) to verify the effect of electrical stimulation on the auditory system. ABRs and ECochGs were obtained from 3 Guinea Pigs before and after each stimulation, and five parameters were extracted from ABR and ECochG waveforms. The results showed that the mean differences of the first peaks of ABR, I, before and after all the stimulus conditions were significant at the significant level of p<0.05. Also, amplitude of ECochGs peak(AP) showed higher degrees of differences for the electrical stimulation than that of ABRs. Based on the results of this experiment establishment of an electrical model which characterizes the auditory system could be achieved by computer simulation. This will lead to the design of most accurate model for the real auditory system, which provide the quantitive information regarding diagnosis and treatment.

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Validity of Nursing Diagnoses Related to Difficulty in Respiratory Function (호흡기능장애와 관련된 간호진단의 타당도 조사)

  • 김조자;이원희;유지수;허혜경;김창희;홍성경
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.569-584
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    • 1993
  • This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC+ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

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Study on the Characteristics of Noise/Vibration in the Upright Laying Hen House (직립식 산란계사 내의 소음 진동 발생 현황 조사연구)

  • Lee S.J.;Chang D.I.;Chang H.H.
    • Journal of Animal Environmental Science
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    • v.12 no.1
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    • pp.21-28
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    • 2006
  • This study was carried out to measure and analyze the characteristics of noise and vibration, and to analyze their effects on the productivity of layers, mechanical troubles, and abnormal wear-out failure of facilities and equipment of the layer house. The measurements of noise and vibration were taken at 13 layer farms nationwide for the operations of feed supplier system, feed distribution system, automatic egg collection system, ventilation system, blot conveyer for layer feces, and fur the case of with and without their operation by a sound level meter and a vibration measuring system in the layer house equipped with upright multi-tier cages. Measurement results showed that normal times were noise(N) 82 dB and vibration(V) 0.2072 cm/s, feed supplier system were 90 dB(N) and 2.8560 cm/s(V), feed distribution system were 90 dB(N) and 2.0222 cm/s(V), automatic egg collection system were 87 dB(N) and 0.1865 cm/s(V), ventilation system 88 dB(N) and 2.5364 cm/s(V), belt conveyer fur layer feces were 88 dB(N) and 0.2387 cm/s(V), and then maximum values of noise and vibration were 90 dB and 2.8560 cm/s, respectively, when feeding systems(feed supplying system and feed distribution system) were operated. Based on these results, an experiment is being conducted to find out the effect of noise and vibration on the productivity of layers in the layer house equipped with upright multi-tier cages.

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A STUDY ON MENTAL HEALTH STATE OF HIGH SCHOOL STUDENTS (고등학생의 정신건강 상태에 관한 연구 -SCL-90을 이용, 서울시 인문계 1 . 3학년을 중심으로-)

  • 김은주
    • Korean Journal of Health Education and Promotion
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    • v.5 no.2
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    • pp.110-141
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    • 1988
  • This study was conducted to find out the mental health state of high school students. First-year students and third-year students af liberal high schools is Seoul were subject to this study. Questionnaire of Symptom Checklist-90 and various factors was adopted for the survey. A total of 916 questionnaires was sellected for the analysis, and the results are obtained as follows; 1) The characteristics in responses to mental health scale showed that obsessive-compulsive scale score was the highest, followed by interpersonal-sensitivity, depression, hostility, and anxiety. The subject group of the students showed higher scores in nine symptom dimensions except somatization than other normal group. 2) Girl-students showed higher scores than boy-students in somatization, depression, and anxiety, whereas the opposite was true in hostility. 3) Third-year students got high scores, in somatization, anxiety and Depression. 4) Parental marriage state of the repondents showed significant differences in nine symptom dimensions of mental health. Scores of the students with parents was the lowest, followed by those of students with only mother, only father and the rest(no parents, divorced, sepaerated, step-parent) in increasing order. 5) Smoking students showed high score in obsessive-compulsive, depression, hostility, paranoid ideation, and psychoticism. Especially in hostility, they got much higher score. 6) Students with poor record at school got higher scores in every symptom dimension than those with good record at school, especially in obsessive-compulsive and depression scale. 7) Parents' attitude toward student showed significant effect on every scale. Students under over-expectation or indifference from parents were in bad mental health state. 8) Students who have advisor proved to be in better mental health state than those who never consult their personal problems with others. 9) He who has family history got higher scores in some scales. 10) Respondents who looked upon what they have learned in high school as being rather an obstacle to sound social life got high scores in all the symptom dimensions and next came those of the students who answered that there were a lot of unnecessary things in their learning. 11) Those for whom it would not quite necessary to enter college if there were little formal schooling discrimination in society got high scores in obsessive-compulsive, interpersonal sensitivity, depression, hostility, and in psychoticism, especially higher in obsessive-compulsive scale. 12) Mental health state of the students who are influenced by the social surroundings, mass media, and the home environments showed high score in 8 symptom dimensions. 13) Abnormal response frequency of this sample is as follows; 24.0% of boys, 23.8% of girls, 22.5% of the first-year students, and 26.9% of the third-year students. There were significant difference among the grades. 14) The factors of distinctive correlation between the dimensions of SCL-90 and 16 factors were the father's negative attitude and depression, negative responses on teaching contents and anxiety, and smoking and hostility. In conclusion, mental health state of liberal highschool students on the whole showed worse than other normal groups. It had close terms with relation with their parents, schoolwork, smoking, teaching contents, the social surrounding, mass media, and the home environments. Thus I believe there need not only mental health education of students, training of teachers, counceling of parents, but also changes in teaching contents, and the improvement of educational system and the social surroundings under the national support.

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Prognostic Factors of Renal Defects on the Initial DMSA Scan in Children with Acute Pyelonephritis (급성신우신염 환아에서 DMSA 스캔상 발견된 신결손의 예후 인자)

  • Seon, Yeong-Seon;Kwon, Duck-Geun;Shin, Yun-Hyea;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.195-202
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    • 2010
  • Purpose : The purpose of this study is to determine if there are prognostic factors leading to permanent parenchymal damages to kidney in children after acute pyelonephritis. Methods : This study was conducted in 160 pediatric patients with acute pyelonephritis admitted to Ajou University Hospital from 2000 to 2005, whose renal cortical defects were confirmed by $^{99m}Tc$-dimercaptosuccinic acid scintigraphy (DMSA scan). Along with the follow-up DMSA scan after 6 months, they were classified into two groups; recovered group (106) and scarred group (54). The clinical characteristics of each group were compared. Results : Among the total of 160 patients, 106 (66.3%) showed recovery of the initial defect (the recovered group), while 54 (33.8%) showed permanent defects on the followup DMSA scan (scarred group). Recovery rate was poor for patients of 1 year and older, or patients with the duration of fever and pyuria longer than 7 days. The recovery rate was poor in the patients with history of frequent febrile episodes and abnormal results of imaging studies, such as voiding cystourethrography (VCUG), ultrasonography. Conclusion : The recovery rate of children with renal defects on DMSA scan with acute pyelonephritis was lower when the patient is older than 1 year, when the duration of fever and pyuria exceeded 7 days, and when the patients had the histories of frequent febrile episodes and had urinary tract abnormalities on imaging studies. These findings suggest that there may be under- or mis-diagnosis of acute pyelonephritis by pediatrician.

Full mouth rehabilitation using orthodontic treatment and implants in patient with collapsed occlusion: A case report (붕괴된 교합을 가진 환자에서 교정치료와 임플란트를 이용한 전악 수복: 증례보고)

  • Ahn, Ayoung;Koak, Jai-Young;Heo, Seong-Joo;Kim, Seong-Kyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.439-447
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    • 2019
  • The distance between the natural teeth and the implants is an important factor in preserving the periodontal tissues and esthetics. And abnormal positional displacement and tilting of the teeth during restorative procedure may require intentional root canal treatment and may affect masticatory function. This report is to present a successful full mouth rehabilitation of a patient with uneven dentition and collapsed occlusion using orthodontic and implant treatment. The patient had no symptoms or discomfort of temporomandibular joint disorder such as pain or sound. The orthodontic treatment was continued until implant provisional prosthesis delivery. And the vertical height of occlusion was elevated 2mm on anterior basis for anterior teeth protection and esthetics. After the orthodontic treatment, the implant abutments and natural teeth were finally restored with porcelain-fused-to-metal crowns and bridges. Satisfactory function and esthetic outcomes are observed after 6months of follow up.

A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System (모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구)

  • 이광옥
    • Journal of Korean Academy of Nursing
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    • v.13 no.1
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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Manganese and Iron Interaction: a Mechanism of Manganese-Induced Parkinsonism

  • Zheng, Wei
    • Proceedings of the Korea Environmental Mutagen Society Conference
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    • 2003.10a
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    • pp.34-63
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    • 2003
  • Occupational and environmental exposure to manganese continue to represent a realistic public health problem in both developed and developing countries. Increased utility of MMT as a replacement for lead in gasoline creates a new source of environmental exposure to manganese. It is, therefore, imperative that further attention be directed at molecular neurotoxicology of manganese. A Need for a more complete understanding of manganese functions both in health and disease, and for a better defined role of manganese in iron metabolism is well substantiated. The in-depth studies in this area should provide novel information on the potential public health risk associated with manganese exposure. It will also explore novel mechanism(s) of manganese-induced neurotoxicity from the angle of Mn-Fe interaction at both systemic and cellular levels. More importantly, the result of these studies will offer clues to the etiology of IPD and its associated abnormal iron and energy metabolism. To achieve these goals, however, a number of outstanding questions remain to be resolved. First, one must understand what species of manganese in the biological matrices plays critical role in the induction of neurotoxicity, Mn(II) or Mn(III)? In our own studies with aconitase, Cpx-I, and Cpx-II, manganese was added to the buffers as the divalent salt, i.e., $MnCl_2$. While it is quite reasonable to suggest that the effect on aconitase and/or Cpx-I activites was associated with the divalent species of manganese, the experimental design does not preclude the possibility that a manganese species of higher oxidation state, such as Mn(III), is required for the induction of these effects. The ionic radius of Mn(III) is 65 ppm, which is similar to the ionic size to Fe(III) (65 ppm at the high spin state) in aconitase (Nieboer and Fletcher, 1996; Sneed et al., 1953). Thus it is plausible that the higher oxidation state of manganese optimally fits into the geometric space of aconitase, serving as the active species in this enzymatic reaction. In the current literature, most of the studies on manganese toxicity have used Mn(II) as $MnCl_2$ rather than Mn(III). The obvious advantage of Mn(II) is its good water solubility, which allows effortless preparation in either in vivo or in vitro investigation, whereas almost all of the Mn(III) salt products on the comparison between two valent manganese species nearly infeasible. Thus a more intimate collaboration with physiochemists to develop a better way to study Mn(III) species in biological matrices is pressingly needed. Second, In spite of the special affinity of manganese for mitochondria and its similar chemical properties to iron, there is a sound reason to postulate that manganese may act as an iron surrogate in certain iron-requiring enzymes. It is, therefore, imperative to design the physiochemical studies to determine whether manganese can indeed exchange with iron in proteins, and to understand how manganese interacts with tertiary structure of proteins. The studies on binding properties (such as affinity constant, dissociation parameter, etc.) of manganese and iron to key enzymes associated with iron and energy regulation would add additional information to our knowledge of Mn-Fe neurotoxicity. Third, manganese exposure, either in vivo or in vitro, promotes cellular overload of iron. It is still unclear, however, how exactly manganese interacts with cellular iron regulatory processes and what is the mechanism underlying this cellular iron overload. As discussed above, the binding of IRP-I to TfR mRNA leads to the expression of TfR, thereby increasing cellular iron uptake. The sequence encoding TfR mRNA, in particular IRE fragments, has been well-documented in literature. It is therefore possible to use molecular technique to elaborate whether manganese cytotoxicity influences the mRNA expression of iron regulatory proteins and how manganese exposure alters the binding activity of IPRs to TfR mRNA. Finally, the current manganese investigation has largely focused on the issues ranging from disposition/toxicity study to the characterization of clinical symptoms. Much less has been done regarding the risk assessment of environmenta/occupational exposure. One of the unsolved, pressing puzzles is the lack of reliable biomarker(s) for manganese-induced neurologic lesions in long-term, low-level exposure situation. Lack of such a diagnostic means renders it impossible to assess the human health risk and long-term social impact associated with potentially elevated manganese in environment. The biochemical interaction between manganese and iron, particularly the ensuing subtle changes of certain relevant proteins, provides the opportunity to identify and develop such a specific biomarker for manganese-induced neuronal damage. By learning the molecular mechanism of cytotoxicity, one will be able to find a better way for prediction and treatment of manganese-initiated neurodegenerative diseases.

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