A new local drug delivery device to treat otitis media (OM) has been developed. This device consists of a biodegradable poly(L-lactic acid) (PLLA) film containing antibiotic (ampicillin, AMP), which can be placed into the middle ear cavity and release the therapeutic concentration of AMP for prolonged period. Biodegradable films containing AMP (10 w/w%) were prepared by solution casting method using a suspension of the drug in a $PLLA/CH_{2}Cl_{2}$ solution (molecular weight of PLLA, 100,000 (100 K) and 300,000 (300 K), respectively). PLLA-AMP films were characterized by FTIR, DSC, and SEM. In vitro release of AMP from AMP-PLLA films were examined. The release pattern of AMP from AMP-PLLA films remained consistent from 1 day to 14 days, and the release rates of AMP from AMP-100K-PLLA film and AMP-300K-PLLA film were $0.7384\;{\mu}g/ml/day$, $0.4107\;{\mu}g/ml/day$, respectively.
Background Accessory auricles (AAs) are common congenital anomalies. We present a new classification according to location and shape, and propose a system for coding the classifications. Methods This study was conducted by reviewing the records of 502 patients who underwent surgery for AA. AAs were classified into three anatomical types: intraauricular, preauricular, and buccal. Intraauricular AAs were divided into three subtypes: intracrural, intratragal, and intralobal. Preauricular AAs were divided into five subtypes: precrural, superior pretragal, middle pretragal, inferior pretragal, and prelobal. Buccal AAs were divided into two subtypes: anterior buccal and posterior buccal. AAs were also classified according to their protrusion pattern above the surrounding surface: pedunculated, sessile, areolar, remnant, and depressed. Pedunculated and sessile AAs were subclassified as spherical, ovoid, lobed, and nodular, according to their body shape. Cartilage root presence and family history of AA were reviewed. A coding system for these classifications was also proposed. Results The total number of AAs in the 502 patients was 1,003. Among the locations, the superior pretragal subtype (27.6%) was the most common. Among the protrusion patterns and shapes, pedunculated ovoid AAs were the most common in the preauricular (27.8%) and buccal areas (28.0%), and sessile lobed AAs were the most common in the intraauricular area (48.7%). The proportion of AAs with a cartilage root was 78.4%, and 11% of patients had a family history. The most common type of preauricular AA was the superior pretragal pedunculated ovoid AA (13.2%) with a cartilage root. Conclusions This new system will serve as a guideline for classifying and coding AAs.
It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.
Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.
Noise may cause damage of the auditory system, hypertension, and cardiovascular disease. However, we haven't the data enough to be available for understanding various effects of noise on the human body. The current study was prospectively designed to investigate the changes of the cardiac factors and cerebral hemodynamics following a transient exposure to noise in young people. 80 subjects (mean aged $23.45\pm2.40$ years) participated in this experiment and were exposed to excavator-noise with 90 decibels for 15 minutes using ear-phone. Cardiac factors such as heart rate (HR), blood pressure (BP) and heart rate-systolic pressure product (RPP), and cerebral hemodynamics such as mean blood flow velocities (Vm), pulsatility indexes (PI), resistance indexes (RI) and mean blood flow velocities at breathing-hold (Vh) in the middle (MCA), anterior (ACA) and posterior cerebral arteries (PCA) were measured before (baseline) and during the noise-exposure. Although there were individual differences in above mentioned parameters, HR, systolic and diastolic BP, RPP, MCA-Vm, MCA-PI, MCA-RI, ACA-Vm, ACA-PI, ACA-RI, PCA-Vm, PCA-PI, and PCA-RI during the noise-exposure decreased compared with the baselines (P<0.05 or P<0.01), The findings of the present study suggest that a transient exposure to excavator-noise at rest causes changes in the cardiac factors and cerebral hemodynamics with individual differences. Further studies need to be carried out for clarifying the effects of longer exposure and combined mental activity with noise exposure.
This research has been made through analyzing clothes of human dresses and ornaments appeared in the Buddhist pictures which were drawn at the times of the koryo Dynasty. Clothes of the Korea Dynasty could be analyzed as below : First, as for Turban (Doogun), common people used Ogun, Doogun, Byunsangmo and Chaek. For clothes, the style of the era of the ear of the Three-Dynasty. That is , they wore long shirts with narrow sleeves and narrow trousers and skirts. However, around the years of 1320, shirts had no more belt but became to show a kind of ribbon which is called as Gorum , and length of shirts was a bit shortened between hip and waist lines. Second, as for officials clothes, a kind of Rhangkan was used through the Dynasty but after the years of 1300, Wonryukwan was also used. In the clothes, Bangshimkikryung was used and the royals wore full-dress attire which looks like a long gown. Under the full-dress , we can see two different which seems to be a kind of present under-water. Third, in public clothes, same type of Danryung. Holl, belt and shoes were used throughout the Korea Dynasty. In addition Line (Yeon) was remarkably used skirt was dressed under Danryung by middle of the Dynasty the skirt was replaced with trousers. For Bokdoo, Jeonkak bokdoo was mostly used at the beginning of the Dynasty , but in the end of the Dynaty a lowr-flap bokdoo was in the main current. Meanwhile , we can see that the Korea Dynasty had its own in dependence in the clothes although the Dynasty was much affected by the Chines Song Dynasty System. We can hardly find a Mogrian cloethes style in the Korea-Dynasty clothes. Fourth, in Queen's clothes, banbi and pyo were used and sleeves were decorated with birds feather throughout the Dynasty. Lastly , famer's clothes are quite similar to those of the Chinese Song and won Dynasties and a decorative line was used in official clothes. These facts make us have a presumption of our Dongii culture might be conveyed to the Chinese in the ancient times but much more research is needed to clarify.
Background: Toll-like receptors (TLRs) detect microbial infection and can directly induce innate host defense responses, which are thought to play critical roles in protecting the tubotympanum from infection. However, little is known about the relationship between TLRs, which are related to innate immunity, and immunoglobulins, which are related to adaptive immunity, in recurrent otitis media with effusion (OME). We therefore investigated the expression of TLR2 and TLR4 and immunoglobulin in children with OME. Methods: The study population consisted of 72 children with OME, 31 with more than 4 episodes in 12 months or more than 3 episodes in 6 months (otitis-prone group), and 41 with fewer than 3 episodes in 12 months (non-otitis prone group). The expression in middle ear effusion of TLR2 and TLR4 mRNA, as determined by Real time- -polymerase chain reaction (RT-PCR), and the concentrations of IgG, IgA, and IgM, as determined by Enzyme-linked immunosorbent assay(ELISA), were compared between the two groups. Results: Expression of TLR2 and TLR4 mRNA was lower in the otitis prone than in the non-otitis prone group, but the difference was not statistically significant (p>0.05). Between group differences in the concentrations of IgG, IgA and IgM in effusion fluid were not significant (p>0.05), and there were no correlations between immunoglobulin concentration and the expression of TLR2 and TLR4. Conclusion: Although there was a trend toward lower expression of TLR2 and TLR4 in the otitis-prone group, the differences, and those in immunoglobulin concentration, did not differ significantly between the otitis-prone and non-prone groups.
The author measured IL-2, IL-4, IL-6, TNF-${\alpha}$ and total protein(TP) level of middle ear effusion(MEE) of 24 ears - 13 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang - of pediatric recurrent otitis media with effusion(PROME) using ELISA assay, and compared the level of cytokines(pg/ml)/TP(mg/dl). And investigated the clinical finding in those children. The results were obtained as follows: 1. The level of IL-2/TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.05). 2. The level of IL-4/TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.0l). 3. The level of IL-6/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.05). 4. The level of TNF-${\alpha}$/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.01) 5. 79.1% of children with recurrent otitis media with effusion(ROME) were also complicated to chronic sinusitis. The children's t-test was used to make a statistical comparison between the groups. According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by control produce of cytokines which are connected with inflammatory reaction.
Key components of implantable hearing aids are consist of an acoustic sensor that collect external sound by suppressing the body noise, a signal processor module for compensation algorithm of hearing loss, and a output transducer which has tiny size but have high efficiency, respectively. In the partial implantable hearing aids, technologies of transducer and signal processor are so matured that can be applied not too much difficulty. However, due to the difficulties in implantable acoustic sensor technology, such as minimization of masticatory sound and damage of sensor's membrane from external impact, practical use of fully implantable hearing aids have not successful so far. In this paper, we have proposed a novel implantable acoustic sensor which has trans-tympanic structure, and is verified that the proposed method can be very useful for fully implantable hearing aids by cadaveric experiments.
Lee, Seung Ho;Park, Woo Sung;Lee, Young Seok;Yu, Jeesuk
Journal of The Korean Society of Inherited Metabolic disease
/
v.14
no.2
/
pp.156-162
/
2014
A 25-month-old boy was referred to the hospital due to large head detected on routine physical examination. At visit, dysmorphic facial appearances, including broad nose, prominent forehead, and coarse face, were noted. Nasal obstruction with nasal voice, prominent adenoids, and bilateral middle ear effusions were detected. His abdomen was distended, and liver and spleen were palpated about 3 finger and 2 finger breadths, respectively. He was operated for bilateral inguinal hernias. The motion of both elbow joints was mildly limited on supination and pronation. Urinary level of glycosaminoglycan was elevated and the enzyme activity of iduronate sulfatase in leukocytes was decreased. The mutational analysis of the gene iduronate 2-sulfatase (IDS) revealed c.263G>A (p.Arg88His) mutation. His developmental scale showed delayed development and there was cardiac valvular involvement (tricuspid regurgitation and mitral valve prolapse). After the diagnosis of Hunter syndrome, enzyme replacement therapy started on a weekly basis without progression of any clinical features. Here we report a case of early diagnosed Hunter syndrome detected by large head on routine examination. Thus, it is important to associate Hunter syndrome in the patient with large head especially, if there is the history of bilateral inguinal hernia and prominent adenoids to increase the possibility of early diagnosis and treatment.
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