Autoimmune recurrent facial palsy and bilateral sudden sensorineural hearing loss following Ramsay Hunt-like syndrome.

OBJECTIVE: To describe the first published case of recurrent facial nerve palsy associated with bilateral sudden sensorineural hearing loss of autoimmune origin. CASE REPORT: A 33-year-old male presented with acute facial palsy on the left following a vesicular herpetic eruption in the external ear canal on the same side. Serologic measurements demonstrated an elevation of IgM antibodies against herpes simplex virus but not for varicella-zoster virus, confirming a Ramsay Hunt-like syndrome due to herpes simplex virus. The following four months, the patient exhibited other three episodes of facial palsy, well responded to steroid treatment. During the clinical course, a sudden sensorineural hearing loss was also diagnosed, initially on the left side and then on both sides. The autoimmune markers such as the antinuclear antibody and the anti-gangliosides antibodies (anti-GM1, anti-GQ1b) were found positive. Despite steroid treatment, hearing did not show any improvement, remaining moderate on the right and severe on the left. CONCLUSION: Recurrent facial nerve palsy and bilateral sudden sensorineural hearing loss could be the expression of autoimmune disturbances. The initial triggered factor could be the herpes simplex virus infection, such as a Ramsay Hunt-like syndrome.

Estimating net changes in life-cycle emissions from adoption of emerging civil infrastructure technologies.

There is a net emissions change when adopting new materials for use in civil infrastructure design. To evaluate the total net emissions change, one must consider changes in manufacture and associated life-cycle emissions, as well as changes in the quantity of material required. In addition, in principle one should also consider any differences in costs of the two designs because cost savings can be applied to other economic activities with associated environmental impacts. In this paper, a method is presented that combines these considerations to permit an evaluation of the net change in emissions when considering the adoption of emerging technologies/materials for civil infrastructure. The method factors in data on differences between a standard and new material for civil infrastructure, material requirements as specified in designs using both materials, and price information. The life-cycle assessment approach known as economic input-output life-cycle assessment (EIO-LCA) is utilized. A brief background on EIO-LCA is provided because its use is central to the method. The methodology is demonstrated with analysis of a switch from carbon steel to high-performance steel in military bridge design. The results are compared with a simplistic analysis that accounts for the weight reduction afforded by use of the high-performance steel but assuming no differences in manufacture.