Audiologic Results of Ossiculoplasty Using Malleus Footplate Assembly: The Comparison between Autologous Incus and Hydroxyapatite

Sun O Chang,Sue Jean Mun,Joo Hyun Park,Chang Myeon Song,Kyu-Hee Han,이준호,Seung Ha Oh 대한청각학회 2011 Journal of Audiology & Otology Vol.15 No.3

Introduction A disruption of the ossicular chain of the middle ear causes conductive hearing loss. Ossicular reconstruction is performed to restore hearings in those patients with congenital ossicular chain anomaly or ossicular chain disruption caused by chronic otitis media or cholesteatoma. A study from Japan with 52 auditory ossicular malformation revealed that 44% of the patients had a fixation of the stapes, 40% had incudostapedial joint defects followed by fixation of the malleus and/or incus and defects in the incudostapedial joint with a fixation of the stapes.1) One of the most common ossicular chain anomalies in Korea was a stapes footplate fixation (54.5%) followed by a mobile stapes footplate with other anomalies (19.7%) including a stapes without suprastructure and an incus long process, stapes without anterior crus and an incus long process.2) One of the most common ossicular chain anomalies is the absence of an incus with or without an intact stapes suprastructure. In incudostapedial deformed ears, ossiculoplasty is mandatory to restore the hearing process. Ossiculoplasty is also needed in cases with incus long process erosion with inflammation. As the most vulnerable ossicles, one report said that incus erosion is found in 80% of the chronic otitis media.3) Austin-Kartush classified ossicular chain disruptions into four categories after 1,151 operation on chronic otitis media. Group A ears with an intact malleus handle and a stapes suprastructure was found in 59.2% followed by group B ears with an intact malleus handle but an eroded stapes suprastructure group.4) In the group of a tympanic membrane and malleus preserved but a stapes suprastructure eroded, ossicular continuity can be restored between the stapes footplate and manubrium of the malleus with the method of malleus footplate assembly (MFA) using either the incus body or if the incus is unavailable, a biocompatible material such as hydroxyapatite (HA).5,6,7) Until now, MFA has proven to be the safe and effective way to restore hearings in such patients.8,9,10,11,12)Though successful results using MFA with either incus body or biocompatible material are reported world widely, there were a few reports on audiologic results after MFA ossiculoplasty in Korea. Authors reviewed our procedure and report hearing results of ossiculoplasty with MFA using either incus or HA. In this paper, a single-surgeon series of 32 MFA operations was analyzed. The cases were limited to autologous interposition grafts performed on Austin-Kartush group B ears in order to provide consistency within the analysis. Subjects and Methods Data collection A retrospective evaluation has been carried out on patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in Seoul National University Hospital. A total of 55 patients with Austin-Kartush type B defect repaired with incus body or HA were identified. Of those, 20 were excluded due to a failure to recover operation records or a lack of no more than 1 year postoperative audiograms. Three patients who had undergone MFA with a homologous incus were excluded in order to provide consistency within the analysis. Finally, 32 cases were enrolled into the study. All procedures were conducted by a single surgeon. All data including previous operations, follow-up duration, age, sex, etiology, materials which were used in the operation, combined mastoidectomy, complications, and revision operations were analyzed. Eustachian tube function was analyzed according to the results of the Eustachian tube test. The status of the middle ear mucosa was described as either 'healthy' or 'inflamed' according to the operation records. Demographic data are presented in Table 1. Analysis of audiologic data Preoperative and postoperative hearing results were evaluated according to the guidelines of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head Neck Surgery Foundation13) an... Background and Objectives: Absence of incus is one of the most common ossicular anomalies and also frequently found in chronic otitis media or chornic otitis media with cholesteatoma. Ossiculoplasty with malleus footplate assembly (MFA) can be an excellent option in the above situations. We reviewed our procedures and evaluated the hearing results of ossiculoplasty using the MFA. Subjects and Methods: This study retrospectively reviews a series of 32 patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in an academic tertiary referral center. The autologous incus or hydroxyapatite (HA) was used as materials for reconstruction. Results: Thirteen of 32 patients (40.6%) had ossicular chain anomaly, 9 patients (28.1%) had congenital cholesteatoma and 8 patients (25.0%) had chronic otitis media with cholesteatoma and 2 patients (6.3%) had chronic otitis media. The patients with ossicular chain anomaly showed the greatest air-bone gap (ABG) closure. Overall, postoperative ABG was 17.7±11.7 dB at postoperative 6 months and 19.7±14.3 dB at postoperative 1 year, compared with preoperative ABG of 37.9±9.3 dB. There was no statistical difference of ABG at postoperative 12 months, 24 months between MFA using incus (n=17) and HA (n=15)(p=0.300, and p=0.563). There was no meaningful difference of postoperative ABG between the patients with combined mastoidectomy (n=10) and those without mastoidecmoy (n=22)(p=0.555). No extrusions occurred.

차량 재도색용 청색 페인트의 분석

박성우,손성건,박하선,박성지,정영호,홍성욱,박종신 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

RC교량의 외관상태지수가 내하력에 미치는 영향

박길현,황선하 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.2

In a regularly intervaled check service, sight checking may not be the best way to check internal problems, but it is a very fit process to examine objectively in a economical point of view. Since sight checking is limited by its quality and quantity, it is necessary to use the small numbers of uncertainties in many different points with our instinct and experiences. Since sight checking is limited by its quality and quantity, it is necessary to use the small numbers of uncertainties in many different points with our instinct and experiences. Because of these certain situations, the condition and the reliability have been evaluated by professional instinct and scientific decisions. Properties of the selected items were standardized with reference to the existing research results and actual data. As for the item that is difficult to represent quantitatively, word variable of the Analytic Hierarchy Process was introduced and standardized so that the objectivity of the subjective valuation was acquired. Results from this study are as followed, It is possible to acquire very reliable appraisal results of the reinforced concrete bridges according to the Analytic Hierarchy Process defined in this study. Result from this study can be applied practically through the application and analysis of the appraisal technique and the procedure with actual data. Verification through the practical uses and improvements are required for the development in this field.

균열밀도에 따른 R·C 슬래브 교량의 내하력 평가

박길현,양승현,황선하,정경덕 朝鮮大學校 建設技術硏究所 2003 建設技術硏究 Vol.23 No.1

Through the exterior features on reinforced concrete slab, crack density and crack originate deflections ratio crack density, decrease percentage of load carrying capacity, crack originate deflections ration and decrease percentage of load carrying capacity were statistically analyzed. Crack density, crack originate deflections ratio and decrease percentage of load carrying capacity are very closely related each other with 0.724, 0.821 and 0.317 of correlation coefficient within 95% of mind level. However, the correlation between crack originate deflections ratio and decrease percentage of load carrying capacity was low. Through the regression equation curve method in which crack density selected as independent variable, crack originate deflections ratio and decrease percentage of load carrying capacity as dependent variable, regression equations were presumed. Equations exist in mind level range of F(0.05, S-curve showed the highest, conformance with 79.5%, 72.2%. The regression equation between CRD or LCCD and CD was also shown. The overall judgement of load carrying capacity of bridges can be possible through the moreover investigation of crack density, the time needed precision could be valuable data for lower maintenance cost, the degree of deterioration of bridges and safety judgement.

구개부에 발생한 다형선종의 처치

하주원,백승,송종운,박충열,이용욱,박홍주,오희균,유선열,김옥준 大韓顎顔面成形再建外科學會 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.6

Pleomorphic adenoma of the palate is the most common of all intraoral salivary tumors. It can occur at any age but it presents most commonly in the 40∼60 age group, and there is no significant sex preponderance. It grows slowly and is usually painless, firm, well-circumscribed nodule. Because of high rate of recurrence, extra-capsular excision including the overlying mucosa and margin of normal tissue is recommended. We report 10 cases of palatal pelomorphic adenoma which have been successfully treated by extra-capsular excision. The surgical defects smaller than 3㎝ in diameter were covered with palatal acrylic splint for the secondary healing. The larger defects were repaired using palatal island flap in 3 cases, rotation flap and buccal fat graft in each 1 case. No patient showed any recurrence or malignant change during the mean follow-up period of 4 years and 9 months. These repair methods seem to be simple, reliable and uncomplicated procedures in the palatal surgical defects.

벽오동(Firmiana sirmlex W.F.Wight) 가지의 수용성 추출액이 작물발아에 미치는 Allelopathy의 효과

박현철,박선일,하상영 東亞大學校生命資源科學大學附設 農業資源硏究所 1997 農業生命資援硏究 Vol.6 No.1

벽오동나무 2년, 3년생 가지를 1월과 4월에 채취하여 수용성 추출액을 희석 농도별 공여작물에 발아 실험하여 Allelopahy의 효과를 조사항목별 결과는 다음과 같다. 발아율은 시료의 년별, 월별에 있어 년별 또 토마토, 벼는 월별 발아억제 효과가 없고 월별은 배추, 갓은 1월에 발아율이 낮았으며, 발아기는 벼가 제일 빨랐으며, 다른 공여작물은 무처리에 비하여 2배 내지 3배 정도의 기간이 더 지연되었으며 발아평균기간은 년수에 관계없이 배추, 갓, 벼는 1월이 지연되었으며, 토마토는 오히려 4월은 지연되었다. 발아양부는 벼를 제외한 공여작물은 4월 채취가 발아양부가 양이었으며, 1월은 불량이 많았다. 농도 30%에서는 중, 불량이었으며, 벼는 년수, 월별, 농도에 관계없이 지수가 양이었다. Two and three years old branches of a Phoenix tree were respectively collected on January and April, and the aqueous extract from the branches was then treated to four tested crops, Chinese cabbage, leaf mustard, tomato and rice, in order to find the allelopathic effects by different concentration of the extracts. Generally, there were allelopathic effects of the aqueous extracts on the tested crops with increment of concentration and regardless of branch ages and/or collecting season. The results were summarized as follows. Germination rate of Chinese cabbage and leaf mustard were lower with treatment of the extracts from the branches which were collected on January. Otherwise, there were no significant effects of the extracts on the germination of tomato and rice. Germination time of rice were greater than other crops which germination time were delayed. Average germination time of Chinese cabbage, leaf mustard and rice were delayed with value of tomato was delayed with treatment of the extracts from the branches collected on April. State of germination of all crops, except rice were high with treatment of the extract on April, and were low on January. In case of rice, it was high without regard to the collection season of branches and concentration of extracts.

부산물 비료에 발효미생물의 첨가가 잎들깨의 생장특성과 수량 증수효과

하상영,박선일,정대수,여수진 東亞大學校 1999 東亞論叢 Vol.36 No.-

공시재료 부산물 비료 3종류에 발효미생물을 혼합하여 재배한 잎들깨의 생장 특성조사 결과는 다음과 같다. 초장에 있어 공기 발효미생물을 혼합한 부산물 비료는 대풍, 바이오청, 풍작 순이며, 엽수의 채엽증가는 바이오청, 풍작, 대풍 순으로 채엽의 수가 증가하였으며, 엽의 길이느 ㄴ처리구에서 엽의 길이가 길어지는 경향은 잇고, 조사 횟수에 따라 엽의 길이에 차이가 있었다. 엽의 폭은 엽의 길이와 같은 경향이 잇으며, 엽의 건물비율은 부산물 비료와 발효미생물의 혼합 유무와 환경요인에 따라 건물비율이 증감하는 것으로 판단되며, 줄기 30cm의 직경은 바이오짐+대풍, 하이그린 J+대풍, 아제론+대풍이 직경이 커지는 경항이 있다. This study was conducted to elucidate the growth characteristics of perilla, Perilla Frutescens, which was cultivated by mixture Fermentative microbe into three types Organic compost. In the height of perilla, Daepung mixed with Fermentative microbe showed the highest level and followed by Biochong and Pungchag in order. Number of the harvested leaves were the highest in Biochong, Pungchag and Daepung in order. Leaf length and leaf width were more effective at the three kinds on Organic compost than Control. The rate of dried leaf weight was decided by Organic compost, Fermentative microbe and Environmental factor. Diameter of perilla stem at 30cm above the ground increased mixture Fermentative microbe and Organic compost and was the thichest in Biojim+Daepung, Higreen-J+Daepung and Ajelon+Daepung.

지방상수도의 운영관리 개선방향에 대한 연구

박우하,김선규,오정진,왕창근 충남대학교 공업교육연구소 1995 論文集 Vol.18 No.1

Deterioration of drinking water quality became a nationwide concern recently. Many small water treatment plants have some problems with selection of facilities as well as operation and maintenance. In an effort to identify the problems and suggest the improvement measures, Korea Water Resources Corporation(KOWACO) have assisted the small local water treatment plants by on-site technical examination since 1990. The results are summarized as follows. 1. More skillful water workers and continued education for the workers are required for better operation and maintenance of the facilities. 2. Continuous and systematic monitoring capability of raw and treated water quality must be increased especially in small water works. 3. Balancing the water budget is a least requirement for adequate operation and maintenance as well as water quality improvement. This can be achieved partially by increasing water rates. 4. Because the technical assistance program for small local water treatment plants through on-site examination by KOWACO has been very successful, it is strongly recommended to enlarge the program.

의사결정 방법에 의한 철근콘크리트 구조물의 상태평가

박길현,황선화,유동원 朝鮮大學校 建設技術硏究所 2006 建設技術硏究 Vol.26 No.1

In this study, a method based on the Analytic Hierarchy Process for systematizing the maintenance and securing the safety of the reinforce concrete bridges using an appearance inspection and state evaluation was proposed. It would be possible for general structure engineers to appraise the bridges with this method. Results from periodical inspections are mostly qualitative because of the inspector's subjective judgment. Therefore, for more objectivity of the results from the safety inspections. quantitative standardization processes of the appraisal items areessentially required. Properties of the selected items were standardized with reference to the existing research results and actual data. As for the item thatis difficult to represent quantitatively, word variable of the Analytic Hierarchy Process was introduced and standardized so that the objectivity of the subjective valuation was acquired. Results from this study are as followed. It is possible to acquire very reliable appraisal results of the reinforce concrete bridges according to the Analytic Hierarchy Process defined in this study. Result from this study can be applied practically through the application and analysis of the appraisal technique and the procedure with actual data. Verification through the practical uses and improvements are required for the development in this field.

위치제어계에서 외란관측기 설계에 관한 연구

박선국,이상관,최부귀,하홍곤 동아대학교 공과대학 부설 한국자원개발연구소 1991 硏究報告 Vol.15 No.1

The dynamics of the Multi―degree of freedom manipulator is highly nonlinear and the compensation against this nonlinearity should be indispensable. This paper proposes the decentralized joint control method based on the distrubance observer where the dynamical equation is not directly solved. This system has excellent performance of disturbance supression, because the total acceleration including the load torque and various kinds of frictional torques can be controlled directly, come experiments show the effectiveness of the proposed system. This paper discuss the important relationships with the feedforward compensation type Servo system using distrubance torque observer.