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A Clinical Study of Hearing Disturbance and Middle Ear Pathology in Chronic Otitis Media (만성중이염의 교실내 병변과 청력에 관한 임상적 연구)

  • 박동석;전재기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.4.4-5
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    • 1979
  • The degree of hearing impairment of chronic otitis media will indicate the nature and severity of middle ear pathology especially condition of ossicular chain, size of ear drum perforation and location of granulation tissue in the middle ear cavity. The subjects were 189 ears of tympanoplasty for chronic otitis media and divided into four groups as follows: Normal ossicular chain with only ear drum perforation (group I), normal ossicular chain with granulation tissue only around the ossicles regardless of any other region (group II), ossicular ankylosis or fixation of handle of malleus to promontory with or without granulation tissue around the ossicle (group III) and ossicular interruption by partial or complete destruction(groupf IV). The results were concluded as follows: 1) The average hearing threshold of chronic otitis media was 44.6 dB and hearing threshold was closely related to the condition of ossicular chain. Hearing threshold became greater in order of normal ossicular chain, ankylosis and interruption. 2) The average hearing threshold of ossicular interrupted group was 49.1 dB and it was greater in the cases of total destruction than that of partial destruction. 3) The hearing loss in the cases of normal ossicular chain with only tympanic membrane perforation was within 45 dB and this level was presumed to represent normal ossicular function. The degree of hearing loss was in proportion to the size of ear drum perforation and when over 45 dB, other middle ear pathology was suggested. 4) In the cases of small ear drum perforation with normal ossicular function, the hearing threshold was within 30 dB. 5) In the type of audiogram, flat type was 30.2% and ascending type 35.4%. Descending type was more frequent in the cases of normal ossicular mobility with granulation tissue around the ossicle and flat type was observed frequently in the cases of ossicular ankylosis. 6) Carhart's notch was seen in 14 cases (7.4%) and observed mainly in ossicular ankylosis. 7) There was no relation between hearing threshold and histopathological type of granulation tissue in chronic otitis media. However the degree of hearing impairment was related to the location of granulation tissue in the middle ear cavity. 8) Authors recognized the granulation tissue compensated the function of interrupted ossicular chain.

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The Changes of Serum Level of Tumor Necrosis Factor-Alpha, Gamma-Interferon and Soluble-Intercellular Adhesion Molecule-1 Relating to the Progression and Treatment of Patients with Pulmonary Tuberculosis (폐결핵의 진행정도 및 치료에 따른 혈청내 Tumor Necrosis Factor-Alpha, Gamma-Interferon 및 Soluble-Intercellular Adhesion Molecule-1의 변화)

  • Kim, Myung-Hoon;Ahn, Joong-Hyun;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1167-1177
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    • 1998
  • Background : Pulmonary tuberculosis is one of the diseases characterized granuloma formation which was controlled by cellular immune reactions. In the process of granulomatous changes, activated alveolar macrophages and T lymphocytes secrete many cytokines including interleukin-1 (IL-1), tumor necrosis factor-alpha(TNF-$\alpha$), interferon-gamma(IFN-$\gamma$) which mediate inflammatory reactions. Intercelluar adhesion molecule-1(ICAM-1) also known to major role player in inflammatory processes, and increased cellular expressions when endothelial cell was stimulated by IL-1, TNF and IFN. Method : To evaluate relationships among cellular immune reactions and clinical stages, pulmonary tuberculosis patients were classified into three groups according to their clinical stages including minimal, moderate and far advanced tuberculosis. TNF-$\alpha$ IFN-$\gamma$, sICAM-1 (soluble form of ICAM-1) were measured at the time of diagnosis and after 6-months anti-tuberculosis medications by radioimmuno assay or enzyme linked immunosolvent assay. Result : TNF-$\alpha$, IFN-$\gamma$, sICAM-1 were significantly increased in moderate and far advanced pulmonary tuberculosis patients but no meaningful changes in minimal staged patients. 6-months anti-tuberculosis medications reduced serum sICAM-1 levels significantly, related to clinical improvement but no significant changes were found in the serum levels of TNF-$\alpha$ and IFN-$\gamma$. In the point of correlations. positive ones revealed between TNF-$\alpha$ and sICAM-1, also between IFN-$\gamma$ and sICAM-1 but no correlation between TNF-$\alpha$ and IFN-$\gamma$. Conclusion : Measurement of serum sICAM-1 could be useful parameter to evaluate the severity of pulmonary tuberculosis and to monitor disease activities during anti-tuberculosis medications.

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Investigation of Diseases of Thai koi, Anabas testudineus (BLOCH) from Farming Conditions in Winter (겨울철 양식장 환경에서 Tai koi, Anabas testudineus (BLOCH)의 임상병리학적 특징)

  • Ahmed, Gias Uddin;Dhar, Mili;Absar Khan, Mohammed Nurul;Choi, Jae-Suk
    • Journal of Life Science
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    • v.17 no.10
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    • pp.1309-1314
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    • 2007
  • Investigation on health conditions of Thai koi (Anabas testudineus) were carried out through clinical and histopathological observations from different farms of Mymensingh district for seven months during August 2006 to February 2007. Fish sampling and water quality parameters (temperature, dissolved oxygen and pH) were monitored on a monthly basis. Clinical examination of fishes was also carried out for any kind of abnormalities at monthly intervals. Samples of skin, muscle, gill, liver and kidney were observed by histological technique. Among the water quality parameters the values of water temperature, dissolved oxygen were found to be at unfavorable level for fish during the colder months in the farms. Clinically it was observed that fishes were more affected from December to January and almost normal in appearance during August to September and February. Different clinical symptoms like scale loss, dermal lesion, ulcer and loss of caudal fin were noticed in December and January. In histopathological study, structures of fish organs were normal from August to September. In the months of October and November, minor pathologies were found to be started. Marked pathological changes like necrosis, pyknosis, inflammation, hemorrhage, hypertrophy, hyperplasia, missing of primary and secondary gill lamellae were observed in the months of December and January. Whereas, in the month of February the pathological condition of fish gradually reduced. Again when considered individual fish farm, fishes of Reliance Aqua Farm were more affected than Sotota Matshya Hatchery. The study showed that severity of clinical and pathological changes were increased in December and January. During the period EUS and protozoan diseases were noticed in A. testudineus of the investigated farms.

Anti-atopic Effects of Castanea crenata Inner Shell Extracts Fermented by Lactobacillus bifermentans (Lactobacillus bifermentans로 발효한 율피의 항아토피 효과)

  • Kim, Bae Jin;Son, Woo Rim;Choi, Mi Ok;Jo, Seung Kyeung;Jung, Hee Kyoung;Lee, Jin Tae;Kim, Hak Yoon;Kwoen, Dae Jun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.9
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    • pp.1378-1386
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    • 2013
  • Atopic dermatitis (AD) is a common skin disease characterized by chronic and relapsing inflammatory dermatitis with immunological disturbances. In spite of the continuous increase in the incidence of AD, it is regrettable that till date there is no effective treatment to treat the same. Therefore, the present study was designed to examine the possible anti-atopic effects of Castanea crenata inner shell extracts fermented by Lactobacillus bifermentans (FCS) in 2,4-dinitrochlorobenzene (DNCB) induced AD in NC/Nga mice. Based on the results of HPLC analysis, we found that FCS contains anti-inflammatory factors such as gallic acid (10.18 mg/g) and ellagic acid (2.14 mg/g). The groups that we have used in this study included 0.1%, 1%, 5% fermented Castanea crenata inner shell extracts (FCS 0.1, FCS 1, FCS 5), 1,3-butylene glycol treated control (AD), and normal mice. After topical FCS treatment, we observed that the clinical severity score for AD was lower in both the FCS 1 and FCS 5 groups than the AD group. We also proved beyond doubt that there was improvement of melanin, erythema and skin moisture indices in the FCS 5 group. Spleen index and gene expression levels of pro-inflammatory cytokines such as IL-$1{\beta}$ and TNF-${\alpha}$ were significantly decreased in the FCS 5 group compared to the AD group (P<0.05). Further, we also found that the level of serum immunoglobulin E (IgE) in the FCS-treated group was decreased in a concentration-dependent manner. The results of our study suggest that FCS can be effectively used as a cosmeceutical ingredient for both the prevention and improvement of AD.

Effect of Magnesium Administration on Preventing Arrhythmias after Coronary Artery Bypass Graft (관상동맥 우회술 후 마그네슘 투여가 심 부정맥을 예방하는 효과)

  • Kim, Jun-Hyun;Song, Hyun;Kim, Yong-Hee;Lee, Eun-Sang;Lee, Jay-Won;Song, Myung-Kun
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.339-345
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    • 1998
  • Arrhythmias are common after cardiac surgery and are multifactorial. Intravenous magnesium administration reduces the frequency of ventricular arrhythmias in patient with symptomatic heart failure or acute myocardial infarction. This study was designed to evaluate the role of magnesium in preventing PVCs(premature ventricular contractions) occurred frequently after coronary artery bypass graft(CABG). 50 consecutive patients were prospectively entered into a randomized trial to determine the efficacy of postoperative magnesium therapy on the incidence of cardiac arrhythmias after elective coronary artery bypass graft. The patients underwent coronary angiography, echocardiography, electrocardiography and clinical laboratory study preoperatively. Continuous electrocardiographic monitoring was done and magnesium level was checked 0, 3, 6, 12, 18, 24, 36, 48, 60 and 72 hours postoperatively. Study group of 25 patients were given 4g of magnesium continuously over the first 24 hours and then 2g/24hours from 25 to 72 hours. The clinical characteristics of both groups were similar(p<0.05). The preoperative mean serum magnesium concentration was similar in both study group, 1.59mg/dl and control group, 1.71mg/dl. The mean postoperative serum magnesium concentration in study group elevated significantly over postoperative 12hours through 36hours(p<0.05). The postoperative mean serum magnesium concentration in control group declined and remained significantly depressed over immediate postoperation through 72hours. The mean serum magnesium concentration was significantly greater in the study group compared with the control group over postoperative 3hours through 72hours(p<0.05). There was a significant decrease in the incidence of arrhythmias such as PVCs(p<0.01) which might jeopardize hemodynamics. There were no recognized adverse effects of magnesium Administration. In conclusion, prophylactic magnesium administration seems to lessen the incidence and severity of rrhythmias after coponary artery bypass graft.

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Protective Effect of Litsea japonica Fruit Flesh Extract on Stress-induced Gastritis in Rats (흰쥐에서 스트레스로 유발된 위염에 대한 까마귀쪽나무열매 추출물의 보호 효과)

  • Park, In-Jae;Park, Sung-Hwan;Yun, Ji-Hyun;Choi, Goo-Hee;Kim, Hyun-Jung;Seo, Yun-Hee;Cho, Ju-Hyun
    • Journal of Food Hygiene and Safety
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    • v.32 no.6
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    • pp.536-541
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    • 2017
  • The object of this study was to investigate the inhibitory effects of Litsea japonica fruit flesh extract (LJF-HE) on gastritis of an stress-induced SD rat model. Rats were randomly divided into six groups: Normal (normal group), Control (stress-induced gastritis), Ranitidine (stress-induced gastritis and ranitidine 50 mg/kg), LJF-HE-L (stress-induced gastritis pretreated with L. japonica fruit flesh extract at 30 mg/kg), LJF-HE-M (stress-induced gastritis pretreated with L. japonica fruit flesh extract at 60 mg/kg), LJF-HE-H (stress-induced gastritis pretreated with L. japonica fruit flesh extract at 120 mg/kg). In groups treated with LJF-HE, gastric mucosal damage and pepsin activity were reduced. Additionally, there were decreases in the expression of cholecystokinin 2 receptor (CCK-2r) in the gastric lesions. The plasma levels of IL-$1{\beta}$ slightly but significantly decreased in LJF-HE treated groups compared to control. The plasma level of PGE2 was also significantly increased in LJF-HE treated groups. These results suggest that LJF-HE has the ability to reduce of the severity stress-induced gastritis.

Differential Levels of Governance and Its Impact on Urban Park Management and Users' Satisfaction - The Case of Sheffield District Parks, UK - (도시공원관리 거버넌스 구축정도에 따른 이용자 만족도 차이 - 영국 셰필드 지구공원을 대상으로 -)

  • Nam, Jinvo;Kim, Hyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.47 no.4
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    • pp.50-60
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    • 2019
  • In the late 1980s, a financial crisis and Compulsory Competitive Tendering (CCT) in green space services brought with it a profound impact on the quality of parks in the UK. Such government projects, e.g. Urban Task Force (1999) and Public Parks Assessment (2001), aimed to raise the awareness of the severity of the declining standards of urban parks. Since the late 1990s, the UK governments (The New Labour (1997-2010) and The Conservative Government (2010-2019)), have often adopted community-led governance schemes to enhance the quality of parks and address problems derived from the financial crisis. Accordingly, community groups, notably 'Friends of', enlarged their involvement in the decision-making process of park management. However, there is little empirical evidence concerning the impact of community-led governance on park management, in particular, the effect on the users' perceptions of park use. This study explored the context of community-led park management to reclassify the level of build-up of governance underlined by 'A Ladder of Citizen Participation'. In addition, questionnaire surveys were conducted around two Sheffield district parks, which are located in deprived areas. As a result, community involvement in the status quo of UK urban park management has changed its form of governance based on the extent of involvement in the decision-making process. The forms of governance could be categorised in three levels: general, active, and predominant governance, where the extents of decision-making and sharing responsibility vary. The results obtained through the questionnaires show that one park (active governance), which has a stronger tendency of sharing responsibility to get involved in park management, had better contribution to park management and positive impacts on users' satisfaction than the other park (general governance). The findings highlight that stronger governance in partnerships with the non-public sectors can shed light on current and future park management through a shift in sharing responsibility for park management.

Factors Associated with Personal and Social Performance Status in Patients with Bipolar Disorder (양극성 장애 환자의 개인적·사회적 기능 상태에 대한 관련 요인)

  • Kim, Min-Jung;Lee, Jeon-Ho;Youn, HyunChul;Jeong, Hyun-Ghang;Kim, Seung-Hyun
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.33-43
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    • 2019
  • Objectives: Bipolar disorder is characterized by repetitive relapses that result in psychosocial dysfunctions. The functioning of bipolar disorder patients is related to the severity of symptoms, quality of sleep, drug compliance, and social support. The purpose of this study was to investigate the association between sociodemographic and clinical factors and functional status in bipolar disorder patients. Methods: A total of 52 bipolar disorder patients participated in the study. The following scales were utilized: Korean version of personal and social performance scale (K-PSP), Korean version of Hamilton rating scale for depression (K-HDRS), Korean version of young mania rating scale (K-YMRS), Korean version of pittsburgh sleep quality index (PSQI-K), Korean version of drug attitude inventory (K-DAI), mood disorders insight scale (MDIS), and multidimensional scale of perceived social support (MSPSS). Results: The K-PSP score showed a negative relationship with K-HDRS score (r = -0.387, p = 0.005), but not with K-YMRS score (r = -0.205, p = 0.145). The K-PSP score showed a negative relationship with global PSQI-K score (r = -0.378, p = 0.005) and overall sleep quality (r = -0.353, p = 0.010). The K-PSP scores were positively associated with the KDAI score (r = 0.409, p = 0.003) and MSPSS score (r = 0.334, p = 0.015). The predictive factors for K-PSP were overall sleep quality and social support from family. Conclusion: Our study showed that depressive symptoms were related to overall function in bipolar disorder. Also, our study suggested that improving sleep quality is important in maintaining functional status. Appropriate social support and positive perception toward the drug may lead to the higher level of functioning. This study is meaningful in that the functional status of bipolar disorder patients is analyzed in a multivariate manner in relation to various variables in psychosocial aspects.

A Case of Late-onset Episodic Myopathic Form with Intermittent Rhabdomyolysis of Very-long-chain acyl-coenzyme A Dehydrogenase (VLCAD) Deficiency Diagnosed by Multigene Panel Sequencing (유전자패널 시퀀싱으로 진단된 성인형 very-long-chain acyl-coenzyme A dehydrogenase (VLCAD) 결핍증 증례)

  • Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.20-25
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    • 2019
  • Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

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Studies on Ancylostomiasis I. An Experimental Study on Hookworm Infection and Anemia (구충증(鉤蟲症)에 관(關)한 연구(硏究) 제1편(第1篇) 구충(鉤蟲)의 감염(感染) 및 구충성빈혈(鉤蟲性貧血)에 관(關)한 고찰(考奈))

  • Lee, Mun-Ho;Kim, Dong-Jip;Lee, Jang-Kyu;Seo, Byong-Sul;Lee, Soon-Hyung
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.1
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    • pp.55-66
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    • 1967
  • In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

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