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.

백서에서 N-dimethylnitrosamine에 의한 간독성 작용에 L-ascorbic Acid가 미치는 영향에 관한 연구

송준민,양승하,변광의,강상균 순천향대학교 1994 논문집 Vol.17 No.2

Toxic effect of NDMA on liver is variable due to dose and duration of administration. Experimental studies showed hemorrhagic necrosis, liver cirrhosis and hepatoma development with NDMA administration. To observe the protective action of L-ascorbic acid on NDMA toxicity of the liver, experimental studies were carried out. Rats were divided into two groups' acute and chronic intoxication. Acute group was divided into three subgroups regarding to dose and duration of NDMA administration, AGI-1(NDMA 40㎎/㎏) and AGI-2(NDMA with L-ascorbic acid 720㎎/㎏), AGII-1(NDMA 20㎎/㎏ for 2 days) and AGII-2(same with AGII-1 with AGII-1 with L-ascorbic acid 360㎎/㎏ for first day, and 10㎎/㎏, 180㎎/㎏ for 2nd and third day). Serological study of liver function and histologic study were carried out 48 hours after NDMA administration. Animal were sacrified on 9th week, then serological and histological studies were carried out. Also ultrastructural observation were performed for the liver tissue. The results were following as : 1. Acute NDMA intoxication group reveals low level of serum protein and albumin while elevation of total bilirubin, alkaline phosphatase and marked elevation of SGOT and SGPT. Histologically, marked hemorrhagic necrosis was noted in the central zone of hepatic lobules. 2. In chronic NDMA intoxication, serological studies showed slight elevation of SGOT and SGPT, and normal levels of total protein, total bilirubin, and ALP. Histologically, swelling of hepatocyte, necrosis of individual cells, enlargement of nucleus with prominent nucleoli were evident. 3. Chronic intoxication of NDMA groups does not showed special difference between NDMA alone and combined L-ascorbic acid administration. 4. Both acute and chronic NDMA intoxication groups showed ultrastructural changes, such as nuclear irregularity, dilatation of cisternae of RER, partially obscured cisternae with increased density of mitochondira, and focal lipid droplet accumulation in the cytoplasm. The above results show that L-ascorbic acid may play a protective role in toxicity of NDMA.

메틸水銀의 心筋毒性에 대한 苦蔘의 影響

송호준,하대호,유교상,박승택,이강창,서부일 대한본초학회 2002 大韓本草學會誌 Vol.17 No.2

Objectives : To evaluate the toxic effect of methylmercuric chloride(MMC) and the protective effect of Sophorae Radix(SR) in cultured mouse myocardial cells, cytotoxicity was measured by MTT assay Methods : Cultured myocardial cells were incubated for 72 hours in the media containing 5~40 ㎛ concentrations of MMC. And also, the protective effect of SR was determined by sulforhodamine B(SRB) for protein sythesis and radioactive assay for DNA sythesis in these cultures. Results : Cell viability was significantly decreased in a dose-dependent manner after cultured myocardial cells were exposed to 20 ㎛ MMC for 72 hours. In the neuroprotective effect of SR on MMC-induced cytotoxicity, SR blocked the MMC-induced myotoxocity in these cultures. Conclusion : It suggests that MMC is toxic against cultured mouse myocardial cells and SR is effective in blocking the meurotoxicity induced by MMC.

중증 두부 손상 환자의 예후 인자에 대한 임상 분석 : Clinical Prognostic Factors

송준석,하은주,이종수,이승재,박효일 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.2

A clinical analysis was carried out retrospectively with 54 cases of severe head injured patients(Glasgow Coma Scale score 3 to 8) in identify prognostic factors. Unawareness for over 1 month, abnormal pupillary reaction, abnormal motor response pattern, and diffuse head injury with basal cisternal compression prove to be the most reliable predictors. Individual predictions of outcome provide a powerful tool for assessing the relative efficacy of alternative treatments.

土當歸, 日當歸 및 中國當歸가 Hydrocortisone acetate로 유발된 瘀血 病態에 미치는 影響

송승현,서부일,김호경,박지하 대한본초학회 2004 大韓本草學會誌 Vol.19 No.1

Objectives : This study was performed to compare the effect of Angelicae Gigantis Radix, Angelicae Acutilobae Radix and Angelicae Sinensis Radix extract on model of blood stasis in rats. Methods : Except for the normal group, hydrocortisone acetate(HA;%mg/kg in ethanol, IM) was injected to induce experimental blood stasis model for 1 weeks and each extract was administrated after lhr following HA injection for lweek. We measured the hematocrit, the platelet count, the prothrombin time, levels of fibrinogen and RBC counts in rat s blood. Results : Angelicae Gigantis Radix, Angelicae Acutilobae Radix group showed significant increase of hematocrit in comparison with that of the control group. Angelicae Gigantis Radix, Angelicae Acutilobae Radix and Angelicae Sinensis Radix group showed significant increase of the platelet count in comparison with that of the control group. Angelicae Gigantis Radix group showed significant decrease of prothrombin time in comparison with that of the control group. Angelicae Gigantis Radix, Angelicae Acutilobae Radix and Angelicae Sinensis Radix group showed significant increase of fibrinogen in comparison with that of the control group. Angelicae Sinensis Radix group showed significant decrease of RBC counts in comparison with that of the control group. Conclusions : Reviewing these experimental results, it appears that Angelicae Gigantis Radix, Angelicae Acutilobae Radix and Angelicae Sinensis Radix have similar pharmaceutical efficacy on model of blood stasis. In particular Angelicae Gigantis Radix showed good efficacy in comparison with Angelicae Acutilobae Radix and Angelicae Sinensis Radix. Therefore further additional study should be conducted to elucidate in depth the pharmaceutical efficacy of these.

무연탄 분말의 사과나무 생산성에 미치는 영향 (1)

宋承達,李容夏,鄭三澤,黃正儀 慶北大學校 1974 論文集 Vol.18 No.-

Effects of coal powder on the apple productivity were investigated from the plant eco-physiological point of view. 1) Light absorption by the dispersion of 10, 30 and 50g/㎡ of 54μ meshed coal powder was 42, 82 and 94% of the incident light, respectively. 2) Leaf area index of the coal treated apple tree on June (nearly maximum) was slightly larger than that of the control plant, i.e., 4.5-5.0 for Jonathan and 5.5-6.0 for Rolls Janet. Relative light intensity under this apple leaf population declined to 3.4-2.4% on June 26, 1974. 3) Application of coal powder on apple tree resulted in an increase of specific leaf area. 4) Assimilation rate measured by the half leaf method showed a decreased rate in the treated leaf. 5) Transpiration rate decreased by 9.6% on the coal powdered leaf. 6) Surplus photosynthesis of the apple leaf population was 31.1-32.7g/㎡/day from the estimation by the formula of Monsi-Saeki. 7) Growth rate of fruit diameter and shoot length showed the obstructive effect of coal treated apple tree. 8) Rate of June drop of the coal treated apple (50g/㎡) increased 11.0-15.7% as compared with that of the control plant.

뇌 경막하 축농

송준석,하은주,이종수,이승재,박효일 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12

Subdural empyema is relatively uncommon condition. characterized by purulent collection in the subdural space. Having presented a fulminating clinical course with very high morbidity and mortality. it is conconsidered as a neurosurgical emergency. In recent years, the mortality of subdural empyema has significantly diminished due to rapid diagnosis, aggressive antibiotic therapy and timely surgical intervention. The condition remains a diagnostic challenge ; CT scanning cannot be relied upon although the use of intravenous contrast and more modem scanner has improved the diagnostic yield. MRI offers earlier and more accurate diagnosis of computed tomographically suspected lesion. We report cases of subdural empyemas. which were diagnosed with MR and operaton. We treated one case successfully and the other postoperative case unsuccessfully owing to a delayed diagnosis.

열교환기 구조 변화에 따른 NH₃와 R22의 성능특성연구

하옥남,하경수,이승재,정송태 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

Nowadays HCFCs refrigerant are restricted because it cause depletion of ozone layer. However, natural gases such as ammonia as an organic compound, propane and propylene as hydrocarbon are easy and cheap to obtain as well as environmental. Accordingly, this experiment apply the NH3 and R22 to study the performance characteristic from the superheat control and compare the energy efficiency of two refrigerants from the high performance. The condensing pressure of refrigeration system is increased from 15bar to 16bar and degree of superheat is increased from 0 to 10℃ at each condensing pressure. As the result of experiment, when comparing the each COP, we knew the NH₃ is suitable as the alternative refrigerant of the R22.

함평만 갯벌 조간대의 식생분포 및 현존량

이승호,이점숙,김종욱,김하송,임병선 木浦大學校 沿岸環境硏究所 1998 沿岸環境硏究 Vol.15 No.1

함평만 조간대 염생식물조사를 위하여 염생식물군락이 형성된 6개지역을 선정하여 식생분포 및 현존량을 조사하였다. 우점군락은 퉁퉁마디군락(Salicoenia herbacea community), 칠면초군락(Suaeda japonic community), 나문재군락(Suaeda asparagoides community), 좀보리사초군락(Carex pumilalini community), 가는갯능쟁이군락(Atriplex gmelini community), 갯개미취군락(Aster tripolium community), 갯잔디군락(Zoysia sinica community), 해홍나물군락(Suaeda maritima community), 갯질경군락(Limonium tetragonun community), 갈대군락(Phragmites communis community), 실망초군락(Erigeron bonariensis community)으로 구분되었다. 염생식물 군락의 생산량은 1,680∼2,170 g.d.w./㎡으로 갈대군락이 가장 높았고, 갯잔디 군락이 310∼500 g.d.w./㎡으로 가장 낮았다. The coastal vegetation was classified by the Braun-Blanquet's method and the biomass was investigated at the wetland of Hampyung-Man. The vegetation of the study area was classified with 11 coastal communities as follows: Salicornia herbacea community, Suaeda japonica community, Suaeda asparagoides community, Carex pumilalini community, Atriplex gmelini community, Aster tripolium community, Zoysia sinica community, Suaeda maritima community, Limonium tetragonun community, Phragmites communis community, Erigeron bonariensis community, Biomass was highest in Phragmites communis community (1,680∼2,170 g.d.w./㎡) and lowest in Zoysia sinica community (310∼500 g.d.w./㎡).

이동 애드 혹 네트워크에서의 환경적응형 QoS AODV 라우팅 프로토콜에 관한 연구

裵振勝,宋東勳,吳世德,鄭燦赫,金玄郁,李光培,文泰洙,郭承郁,河載承 明知大學校 産業技術硏究所 2004 産業技術硏究所論文集 Vol.23 No.-

In this paper, we propose a bidirectional mobile Ad Hoc routing protocol based on AODV(ad-hoc on-demand distance vector routing) with QoS(quality of service) support. At presence, wireless mobile communication focuses on how to efficiently support mobility of users more than QoS guarantee. However, in order to satisfy requirement of various applications which have been or will be served, QoS guarantee between end points is a very important issue. The existing AODV routing protocol is implemented to use only BE (Best Effort) service. However, actual wireless mobile environment requires to reduce a waste of communication resources and meet with the real-time change of data paths by setting up routes with QoS support, considering available communication resources at each node in advance. Therefore, in this thesis, we propose an adaptive QoS support method using hello message in order to rapidly meet with the change of available communication resources and to smoothly perform route maintenance. For performance evaluation, we analyzed the average data reception rate. At that time, we used evaluation parameters such as node's mobility-stop time, hello message period, and packet priority, considering the node's mobility and the number of best effort/QoS data flows. As results, we found that with our proposed method the average data reception rate was increased 16.293%, 15.914%, 17.238% for 300 mobility-stop second case and 4.809%, 4.264%, 2.956% for 300 mobility-stop second case.