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(1)A. c Ⅱ nic 田 s 廿Ⅰ dy. on 丑 t le intervaIform. ofca Ⅰbon mono. ㎡ de. into ㎡ Ca 廿 On TakesH@. Matsui. hi. Tatsuro@Nagasaki. Nobuo゜iⅡ ike@ Anne Millar@) 1)@Yokohama@Naton2@ UniverSty,@Facuy@of@Education@and@Human@Sci nces,@Department@of@SpeC3 Ⅰ. Educa. Ⅰ. on. 2)@Fu@sawa@Municipal@Hospit3.@Department@of@Psychi try 3)@Osaka@City@UniverSty,@School@of@MediCne,@Department@of@Psychi try 4)@Yokohama@Ciy@Uni. erSty,@Scho0@of@Medi ine,@Department@of@Rehabilitaton. Abstract Longiudin3@. study@of@4@ cases@of@the@interv@@form@of@carbon@monoxide@. presented@ aong@wih@the@ resu. Ⅰ. s@of@computerized@tomography@. (CO)@ intoxi a on@i Ⅰ. (CT)@ and@ magnetic@resonance. imaging@ (MRI) The@luCd@ interv3.@ whi h@ describes@the@interv@@ between@ the@acute@phase@of ・. intoxicaton@and@the@emergence@of@the@de 8l@four@cases@the@most@. incontnence,@. characteFs. Ⅰ. yed@neuro. Ⅰ. c@. ga@@ di turbance@ and@ mu. Ⅰ. gi 3@ seque. symptoms@were@ment8@ Ⅰ. Ⅰ. e,@vaEed@from@17@to@32@days ， In. deteriora. Ⅰ. on,@ u Ⅱ. nary@and@feca. sm ， In@ two@ of@the@ cases@ other@ neuropsychological. symptoms,@such@as@spaCal@agnoSa,@finger@agnoSa,@and@dresSng@aprax@@ were@experienced@in@two@of the@. cases. ， CT@scans@in@3@of@the@4@cases@showed@low@denSty@area@in@the@whie@matter@of@the@frontal. l be@as@the@neuropathologi. 3@ substrate@invo ed The@one@case@whose@CT@scan@showed@no@abnorm3 Ⅰ. Sgns@in@the@whie@matter@was@inves. ・. gated@wih@MRI@and@an@area@of@abnorm3iy@was@identfied@in@the. Ⅰ. periventricular@regin@of@the@front3@ be Ⅱ. Name@and@Address@for@the@correspondence Name:@ Dr ．Takeshi@Matsuishi@. Yokohama@National@University. ， Faculty@of@Education@and@Human@Sciences. Department@of@Special@Education Address:@79-2 ， Tokiwadai ， Hodogayaku. ， Yokohama@City. ， 240-8501 ， Japan. ，.

(2) 98. Takeshi@Matsuishi， Tatsuro@Nagasaki， Nobuo@Kiriike， Anne@Millar. Introduc4on. In@1906.@Siberius@C ． first@described@the@interval@form@of@carbon@monoxide@intoxicaton@as@a@series@of. neurologi al@symptoms@whih@appear@following@a@lucid@interv3@ of@variable@duration@after@the@acute phase@of@intoxi. a on ， C Ⅰ. Ⅰ. ni. a. Ⅰ. y@@@ is@characterized@by@va. symptoms,@the@most@common@being@ga@@. Ⅱ. ous@neurologic3@. and@psychologic3. di turbance,@mental@deterioration,@u. Ⅱ. nary@and@fec8. m ，. i continence@and@muti. In@the@interv8@form@of@carbon@monoxide@poi. oning@the@white@matter@of@the@front3@ lobe@@@ involved. ・. Some@believe@hypox@@to@be@the@main@pathologi 3@ factor@but@th@@ 3one@cannot@expl3n@the@change leading@to@demyCination@(Brie. Ⅱ. ey@and@Graham,@1984). ・. It@has@been@suggested@that@Co@has@a@speCfic. cytotoxic@effect@and@causes@a@condiion@known@as@Grinkers@myClinopathy@along@wih@a@reducLo blood@flow@(Gi sberg@et@al ,@1974) ・. To@high In@the@l erature@the@interval@form@of@Co@intox@ a on@has@received@litle@attention Ⅰ. ㍉. severe@form,@ the@authors@present@4@cases@in@det8l. Ⅰ. ・. ， CT@and@MRI@were@used@to@. ght@this. inves gate@the Ⅰ. degenerative@changes@induced@in@the@br3n@in@an@attempt@to@shed@some@light@on@the@pathogenesis@of this@form@of@Co@i. toxication. Furthermore》he‖uthors‘xplored》he‘ffect｛f｛xygen‖t”igh｝ressure・or”yperbaric oxygen@treatment(HBo)@whi. h@have@in@the@past@been@confined@to@the@treatment@of@the@acute@form@of. CO@i toxication,@but@show@promi ing@signs@@@ the@treatment@of@the@i terv@@ form. CASEヽEPORTS C ㎎E. 工. ・. BJ ， ,@a@57-year-old@man,@had@been@depressed@for@over@one@year@due@to@buSness@failures 5th ， 1984@he@attempted@sui. i e@by@asphyxiating@himself@w@h@car@exhaust@fumes. had@a@change@of@mind@and,@in@a@drowsy@state,@beckoned@to@a@passerby@for@hCp taken@to@hospi8. ・. On@ admi. Son@neurologi. consCous@state@except@for@an@occasion@@ days. 3@ examinaton@was@norm8@. lapse@into@dCi. Ⅱ. um. ・. On@June. During@the@act@he. ・. ， He@was@immediatCy. and@he@ rem3ned@in@a. ， The@pa. Ⅰ. ent@was@di. 姑 er. charged. 5. ・. The@pa. Ⅰ. ent@remained@in@this@lucid@. state@for@31@days@before@the@appearance@. symptoms@characteristic@of@the@interv3@ urinary@and@fec8@ incontnence,@muti. form@of@Co@poi im,@ and@g3t@di. oning Inii3ly@the@paLent@expe ・. turbance. ・. The@pati nts@condi. deteriorated@and@within@a@week@he@had@fallen@into@an@almost@complete@ap8lic@state point@ he@was@readmitted@to@hospital ， On@neurologi and@was@unable@to@vocali. e. ・. no. Ⅰ. enced. on@steadily. ， It@was@at@this. Prominent@6lateral@Gegenh8ten@was@present@in@the@upper@limbs@and. present@and@exaggerated@and@the@patient@had@a@poStive@Babinski@sign m@was@. Ⅰ. Ⅱ. 8@ examina Ⅰon@he@was@unresponsive@to@stimuli. primitive@reflexes@such@as@the@grasp@and@sucking@reflex@Wore@Cicited mechani. of@neurologic3. ced@ and@the@ pa. Ⅰ. ・. ・. Deep@tendon@reflexes@were. No@diturbance@to@the@swallow. ents@ sleep@ cycle@was@undisturbed. ， Pulmonary@and. cardiovascular@systems@were@unlaffected‖nd〕aboratory》ests〉eve8ed］o」isceral compli ations otherthan. alowerU.T.I.

(3) A@Cini 3@ study@on@the@interv@@ form@of@carbon@monoxide@intoxica Ⅰ on. The@pa. ent@rem3ned@hospia. Ⅰ. Ⅰ. zed@for@two@months@where@h@@. ， OccaSon3ly@he@vocalied@Smp. unchanged. over@h@@ extremii. regained@some@contr0@. condiion@remained@almost. words@such@as@. Ⅰ. 99. "Yes"@ or@ "Good@morning"@. s@yet@he@had@4fficu y@h0Rng@a@poSt@. He. ・. n@and@incli ed@to. Ⅰ. extend@h@@ spi e An@i crease@@@ the@patients@sexu@@li i o@was@eVdent@and@he@continuously@touched ・. h@@ geni3@organs w@h@@. ・. On@admission@a@CT@scan@reve8ed@a@diffuse@area@of@low@denSty@extending@broadly. the@whie@matter@of@the@cerebrum. EEG@reveaed@low@voltage@de. Ⅰ. ， These@fin4ngs@rem@ned@unchanged@after@two@months. a@and@theta@waves. Alpha@waves@were@not@detected. ・. ・. ． An. After@a@year@the. CT@scan@showed@that@the@difuse@atrophy@of@the@br8n@and@the@low@ densiy@area@had@become excIuslvelycon 且nedtothe. 五五Ⅰ. on ぬllobe. Cム SE 2. M C ,‖”ea hy・・. hospi3｛n｀arch・. Ⅰ. ・. bCng@dicovered@@@ 3cohol,@M. a@comatose@state. ， C ， passed@out@in@h@@. On@the@Ⅰ ght@of@the@22nd,@after@consumi g@copius@amounts@of. ・. car@which@was@parked@in@the@garage@with@the@engine@running. following@morning@he@was@dicovered@and@mshed@to@hospial. ・. The. On@admision@a@CT@scan@showed@areas. ・. of@low@denSty@in@the@globus@p3lidus@and@the@intern8@ capsule An@EEG@recorded@d@fuse@theta@waves ・. of@moderate@ampliude@wih@a@frequency@of@GHz. immeditCy@underwent@oHP@. ・. Alpha@waves@were@rarely@recorded. ・. The@patient. therapy@but@due@to@the@devel pment@of@pulmonary@edema@had@to@be. dicontinued@after@the@first@treatment ， The@pa appeared@he@had@made@a@full@recovery. ent@gradu3ly@became@more@8ert@and@after@one@week@i. Ⅰ. A@CT@scan@at@th@@ Ⅰme@showed@Smilar@Sgns@of@recovery@with. ・. a@decrease@in@Sze@of@the@low@density@area@of@the@globus@p3lidus@and@the@intern3@ capsu Ⅰ・ An@EEG. recorded@alpha@waves@of@9Hz@whih@were@ocCpi3ly@dominant@and@of@moderate@ampliude@(40@-@80 mmvol.. HWewen. Ⅰ・. The@pati compli. 廿la廿oncausedam0deratelncrease. nt@rem3ned@in@th@@. progressed@and@by@April@12th@cou prominent@and@the@pa. ⅠⅠ. and@expe Ⅰ. on. Ⅰ. Ⅱ. enced@u. Ⅱ. respond@to@his@name. nary@incon ・. a s 牡0ng tendency to eX end hissplne md 彊. Ⅰ. waves. luCd@state@for@17@days@before@the@appearance@of@neurologi. atons ， He@became@mutit@@. ofwaIklng buthad. thet. ent@adopted@abnorm8@. Ⅰ. nence. ， Demen. Ⅰ. 3. a@rapidly. Wih@the@@d@of@others@he@was@capab Ⅱ. Ⅰ. keIy t0 Iem bac ㎞打d.Ine れiawas. postures@for@long@periods@of@time ． H@@ IQ@was@found@to. be@below@33@by@the@cubic@test@of@Korse. In@the@ea Ⅱ y@weeks@of@the@interv3@form@of@Co@poioning@the@patient@underwent@oHP@therapy was@treated@d@ly@however@after@10@sesSons@@@. ， He. was@discontinued@as@@@was@judged@ineffective ， On@May. 4th@he@was@transferred@to@a@hospit3@ for@long@term@rehabilia Ⅰon Urinary@incon@nence@diappeared ・. and@h@@ gait@became@more@stable@yet@Parkinson's@di. neuropsycho. ease@prev8led. ・. A@few@months@later@cert8n. gic3@ symptoms@appeared@the@most@obvious@bCng@dresSng@apraxia,@spacil@agnoSa,. Ⅰ. finger@agnoSa,@dicalculi .@and@construction@@ apraxia On@August@14th@h@@ IQ@was@es@mated@to@be@59 ・. by@the@WAIS@test ， On@August@9th@an@EEG@recorded@Sow@3pha@waves@with@a@basic@rhythm@whih were@ocCpia. Ⅰ. y@dominant ， By@November@9th@h@@. EEG@was@norm3. ， A@CT@scan@showed@the@low. denSty@areas@of@the@globus@p3lidus@and@the@internal@capsu to@be@reduced@in@Sze@and@more@ cleaFy Ⅰ. demarcated. 柄戸 etheC ⅠⅠⅡ. Ⅰ. sc. 荻ⅠⅡ evealedn0abnonna. Ⅱ. 止ieslnthewhitema. 甘er 柳 Mlusc Ⅰ. ㎝Ⅰ. clearly.

(4) 100. Takeshi@Matsuishi， Tatsuro@Nagasaki， Nobuo@Kriike ， Anne@Millar. identfied@an@area@of@abnormality@in@the@perivent cular@region@of@the@front3@lobe@suggestive@of Ⅱ. demyelina on@of@the@whie@matterFurthermore@it@reve3ed@a@difuse@atrophy@of@the@br3n@resulting Ⅰ. ・. largely@from@atrophy@of@the@white@matter. A丘 December@26th@he@was@dicharged@from@hospit3 ， Presenty@he@reSdes@with@h@@ wife,@he@rem8ns@in@a. Cム SE 3.. S ， M ， ,@a@47-year-old@m3e@was@in@a@state@of@depresSon@due@to@marit3@ problems ， On@A. he@attempted@suiide@by@asphyxitng@himse Ⅰ. Ⅰ. Ⅰ. gust@21st,@1978. with@car@exhaust@fumesHe@was@dicovered@4@hour ・. ter@in@a@comatose@state The@patient@rem3ned@unconscious@for@72@hours@un l@gradu3ly@he@reg8ned Ⅰ. ・. consciousness week@. Ⅰ. ・. After@a@17@day@lucid@interval@he@became@restless@and@started@wandering@aimlessly. ter@he@expe enced@dificu y@w3king,@h@@ Ⅱ. movements@were@retarded@and@mutis. Ⅰ. fell@into@an@ap3l@@state@and@was@hospi8i. On@admiSon@neurological@examina musCe@rigidity@in@8l@limbs. ・. Ⅰ. ed. Ⅰ. ・. A. c He@then ・. ・. on@reve8ed@bi ter3.@exaggerated@deep@tendon@reflexes@and Ⅰ. Urinary@and@fec3@. incontinence@were@a. Ⅰ. immeditCy@underwent@oHP@therapy@and@after@9@sesSons@he@was@capab. o@recogni ed ， The@pa. Ⅰ. ent. of@conversing ， At@this. Ⅰ. stage@the@pa ent@exhibied@Korsakov@syndrome@3ong@with@cert@n@neuropsycho Ⅰ. Ⅰ. gi 3@ symptoms. An@increase@in@the@patents@sexu3@ libido@was@also@noticed ， After@20@sessions@of@oHP@therapy@the patents@incon. Ⅰ. nence@di appeared@but@due@to@fnancial@restrictions@the@treatment@had@to@be. di con nued ， S ， M ． was@discharged@and@transferred@to@a@ment3@ hospi3 ， Ⅰ. The@pattern@of@the@patients@EEG@and@CT@findings@are@as@follows At@the@onset@of@the@delayed ・. neuro gi 3@ compli aLons@the@EEG@recorded@delta@and@theta@waves@of@moderate@amplitude@in@the Ⅰ. front6@ region CT@scan@reve3ed@a@low@ denSty@area@in@the@whie@matter@of@the@frontal@lobe， On ・. October@3rd,@EEG@recorded@a@lower@ampliude,@faster@wave@pattern@and@by@october@23rd of@moderate@ampliude@with@a@frequency@of@loHz@were@recorded But@subsequent@CT@scans@showed ・. lobe@to@markedly@increase@in@Sze At@no@ me@were@low@denSty the@low@density@area@in@the@front3@ Ⅰ. ・. areas@in@the@globus@p8lidus@observed ， CASE@4. D S ，， a@44-year-old@male ， was@heavily@in@debt@and@on@January@25th ・. asphyxiation@w@h@car@exhaust@fumes lasted@for@2@hours di turbance@ensued. ・. ， 1982@he@attempted@suicide@by. Six@hours@later@he@was@dicovered@in@a@comatose@state@. Fo owing@a@symptom@free@period@of@32@days@urinary@incon Ⅰ. ・. ・. The@pa. Ⅰ. Ⅰ. whi h. nence@and@gait. ent@began@to@f3l@into@an@ap3l@@ state@and@on@March@10th@was@admited. to@hosPtal@for@oHP@therapy. On@admisSon@neurologi Gegenha. Ⅰ. commenced@. al@evalua on@reve3ed@he@was@mutisti. en@was@evident ， The@pa. Ⅰ. Ⅰ. ent@a o@had@a@poS. and@after@sever3@sesSons@D. Ⅰ. ・. S cou ・. Ⅰ. Ⅰ. .@primiive@reflexes@were@Ci ited@and. ve@bilater8@ pyramid3@ Sgn ， OHP@therapy. respond@to@h@@ name@and@eat@with@assi. Gradually@he@became@more@independent@and@capable@of@moving@his@limbs. tance ，. ， While@sitting@he@had@a.

(5) A@clinical@study@on@the@interval@form@of@carbon@monoxide@intoxication. strong@tendency@to@extend@his@spine@and@h@@ present@and@. Ⅰ. Parkinson's@di. ， After@11@ sessions@he@could@walk@Sowly@despie@the@presence@of. ease. ・. Various@neuropsycho. dresSng@apraxia,@and@construc. Ⅰ. ent@progressed@to@a@comp. Ⅰ. Korsakov@syndrome@was. ・. sted@for@2@weeks ， By@March@20th@he@had@completed@8@sessions@of@oHP@treatment@and. was@able@to@converse@Smply. The@pa. body@became@very@rigid. 101. 8@ symptoms,@inCuding@vi. Ⅰ. apraxia,@were@experienced@whi. on3@. uospati3@ agnoSa,. h@di appeared@after@a@month. ・. te@recovery@and@returned@to@h@@ former@job ， The@EEG@sequence. Ⅰ. was@as@followS@On@admisSon,@high@vo. age@de a@waves@in@the@front8@regi n@were@recorded@but@by. Ⅰ. April@30th@a@normal@EEG@was@obt8ned. admi Son@a@prominent@low@. g. Ⅰ. Ⅰ. Smi. ・. Fy@the@CT@fin4ngs@reflected@the@patients@recovery ， On. Ⅰ. densiy@area@in@the@frontal@lobe@was@observed@which@gradua. Ⅰ. y. disappeared@and@by@June@20th@3most@no@abnormaliⅠes@were@recognized@except@for@a@Sight@di tation Ⅰ. of@the@4th@ventricle. Discussion Neuropathologi Ga. Ⅱ. al@substrate@in@the@acute@form@of@Co@poi oning@@@ d fusely@distributed@@@ the@CNS Ⅰ. and@and@Pearce(1967),@. studying@vi ms@at@necropsy,@found@a@preponderance@of@low@densiy Ⅰ. areas@in@certain@areas@of@the@gray@matter,@in@particular@the@globi@pal hi pocampus@and@the@PurkiHe@cCl@ a. Ⅰ. yer@of@the@cerebC m Demyeli. Ⅰ. Ⅰ. o@identified@in@the@whie@matter@of@the@cerebrum. of@neuro. Ⅰ. ・. di,@the@basal@gang. Ⅰ. Ⅰ. Furthermore@they@observed@that@no@combination. findings Sawada@et@3 C3m@that@the@pa ・. in@the@grobus@pa idus@showed@poor@ Ⅰ. interv3@ form@of@Co@poi. Ⅰon@as@all. states. In@th@@ di cusSon@we@will@focus@on@the@re ・. a,@the. at@ n@and@necrotic@ Sons@were. ・. gi 3@ and@psychi tric@symptoms@could@be@regarded@as@specific@for@Co@intoxica. may@be@encountered@in@other@hypox@@. Ⅰ. Ⅰ. Ⅰ. Ⅰ. Ⅰonship@between@clini. 8@ presentaton@and@CT@scan. ents@whose@CT@scan@demonstrated@marked@low@denSty@area. ng-term@prognosis ， Sawada@et@a,@however,@fai. oning@and@is@assoCated@neuropathol. Ⅰ. d@to@refer@to@the. gical@changes ， From@the@findings@of. our@4@cases,@the@interv3@ form@of@Co@poisoning@presents@a@different@Cinic3@. scenario ， In@essence@the. neuropathologic3@ substrate@appears@to@be@confned@to@the@wh*e@matter@of@the@cerebrum,@in pa ㎡ cularthe. on ぬllobe.Carb0nmono. Ⅰ五二. ㎡ delsthoughttohaveaspecl. 行. cc 舶ot0 刈 ce 丘ectresul 廿ng. in@the@neuropathologi @@ condition@know@as@Grinkers@myellinopathy@ (Grinker,@ 1925.@LapreSe@and Fardeau,@ 1966) However,@the@degenerative@changes@induced@during@the@acute@phase@may@prevail ・. into@the@interv6@fo Ⅲ accouting@for@the@presence@of@low@denSty@areas@in@the@gray@matter ， Ⅱ. Of@the@four@cases@of@the@i terv8@ form@of@Co@i tox* ation@presented@here@3@clearly@demonstrate@the main@Ste@of@pathology@to@be@the@whie@matter@of@the@cerebrum,@in@parti conSsted@w@h@the@findings@of@Yoshii@et@8 and@ described@ Smiar@CT@. ular@the@front3@lobe ， This@i. ， (1980)@ who@studied@the@interval@form@of@Co@poi. Ⅰndings ， In@the@cases@presented@here@the@findings@of@the@. ref4 cted@the@pattern@or@Sgns@and@symptoms. ・. oning. CT@scans. Case@3.@S M ,@after@a@luCd@interv@@of@17@days@began@to ・. ・. exhib@@ the@Cini al@features@of@the@interval@form@of@Co@poi oning A@CT@scan@reve8ed@a@low@denSty ・. area@in@the@white@matter@of@the@front@@ lobe@whi h@progresSvCy@increased@in@size the@pa ents@symptoms@became@more@severe@and@was@subsequen Ⅰ. Ⅰ. ・. Correspondingly. y@admitted@to@a@ment8@. hospi8.

(6) ， Tatsuroägasaki ， Nobuo゜iriike ， Anne｀illar Takeshi｀atsuishi. 102. Case@ 1@presented@wih@a@Smilar@pattern. [email protected] S ， ,@had@a@32@day@symptom@free@period@before. ・. ・. f3ling@into@an@ap3l@@state ， At@th@@ point@a@CT@scan@reve3ed@a@prominent@low@denSty@area@in@the whie@matter@of@the@frontal@lobe Th@@ patent@was@unique@as@he@immediately@underwent@oHP@therapy ・. whi h@was@continued@until@the@patent@made@a@3l@recovery s@iden fiab. with@amost@no@abnorm3iti. Ⅰ. Ⅰ. s@here@indi ate@a@posSb@@. ro. A@CT@scan@mirored@the@patients@recovery. except@for@a@Sight@ditation@of@the@4th@vent ⅡCe ， The@use@of. Ⅰ. Ⅰ. OHP@therapy@has,@in@the@past,@been@confined@to@pa the@resu. ・. Ⅰ. ents@suffering@from@acute@Co@poi oning,@however. for@@@in@the@treatment@of@the@interv8@. Ⅰ. form@of@Co@intoxi. a Ⅰ on. ・. Case@2@presented@with@a@somewhat@different@CT@profi Ⅰ・ During@the@acute@phase@the@patient@exhibied a@characteris c@CT@scan@with@ w@denSty@area@in@the@globus@p3lidus@and@the@intern3@ Ⅰ. capsu. Ⅰ. low@density@areas@decreased@in@size@as@the@patient@recovered@from@the@acute@phase lucid@ interval,@ the@ delayed@neurologi. 3@. symptoms@characte. Ⅱ. sⅠ. Ⅱ. y@identiied@. an@. After@a@17@day. c@to@ the@interval@form@ of@Co. poi oning@appeared ， Although@no@abnorm3ities@in@the@whie@matter@were@v@ scan@Cea. ・. These. Ⅰ・. ible@on@CT@scan,@an@MRI. area@of@abnorm8iy@in@the@periventricular@region@of@the@front3@. suggestive@of@demyCination@of@the@white@matter patents@wih@the@interv3@ form@of@Co@poi. ・. Ⅰ. be. Choi@(1983)@8so@reported@the@results@of@CT@scan@on. oning Of@the@17@cases@examined@5@showed@bi. Ⅰ. ・. ter3@ areas. of@low@density@in@the@bas3@ gangli .@2@showed@areas@of@decreased@denSty@in@the@whie@matter@and@the rem8ning@10@showed@no@abnorm3ities symptoms@experienced@. ・. Ⅰ. ng@the@degenera. Ⅰ. d@to@make@any@correlatin@between@the. in@the@nervous@tissue,@@@@@ therefore@dificu. and@the@degeneratve@changes@. to@make@any@remarks@regarding@the@@ corrCa. Ch0.@however,@f8l. Ⅰ. findings ， UnfortunatCy,@the@number@of@reported@cases. ve@changes@with@the@Cini. al@Sgns@are@few. p0nt@of@vi w,@the@resu s@obt3ned@here@suggest@the@whie@matter@ Ⅰ. symptoms@experienced@in@the@interv3@. The@ro. Son@@@ responSb. Ⅰ. al. for@the@Cinial. form@of@Co@poi oning ，. Ⅱ. c@oxigen@TherapYA@Committee@Report)@and@requ. Many@authors@have@demonstrated@that@increased@parti in@humans@(Britten@and@Myers,@1985@. (Brown@and@Pi Ⅰ. From@a@Cinicopathologi. of@oHP@or@HBo@therapy@in@the@treatment@of@the@carbon@monoxide@poi oning@cannot@be. Ⅰ. ignored@ (Hyperba. c. Ⅱ. ・. Ⅰ. es@immedi. te@inves. l@pressures@of@oi@hasten@CoHb@di. Ⅰ. gation. ・. soci ton. Pace@et@8 ， ,@1950) SimilaFy@restoration@of@mitcondrial@function ・. ntadoS,@1989)@may@be@related@to@the@therapeutic@effect@of@oHP. ・. imed@that@the@effect@of@oHP@pertains@to@the@involvement@of@polymorphonuCear@. Recen. Ⅰ. y@@@has@been. ukocytes@in@Co-. Ⅰ. medi ted@neurologi al@iⅠ ury@(Thorn,@1993a) ， From@clini al@experience,@oHP@therapy@is@regarded@as an@effectve@treatment@of@acute@Co@poisoning@however@is@effec establi hed. ・. Thorn@et@al (1995),@in@ a@randomly@controlled@t ・. Ⅰ. Ⅱ. vity@his@not@yet@been@sci n Ⅰ fic3. Ⅰ. 3.@investigated@the@effect@of@oHP. therapy@is@case@of@acute@Co@intoxi ation@and@found@the@treated@group@to@have@a@lower@incidence@of neurologic3@ sequCae In@Japan@oHP@therapy@@@ From@the@resu. Ⅰ. 3so@been@used@in@the@treatment@of@the@interv@@. s@presented@in@th@@paper@and@from@other@studies@. appear@that@treatment@with@oHP@most@effec. Ⅰ. form@of@Co@intoxication ．. (Kawasaki@et@al ,@1982)@ @@ would ・. ve@when@commenced@at@the@onset@of@the@interv3@. form. Hence,@eaFy@diagnosis@@@ essenti3 During@the@inii l@anoxic@insu or@the@ tent@period,@however,@no Ⅰ. ・. Cini 3@ Sgns@di uncompli. tingui h@the@pa. ated@recovery. Ⅰ. ents@des. Ⅰ. Ⅱ. ned@to@suffer@relapses@from@those@who@wi. Ⅰ. have@an.

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