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.-

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.

새로운 세파로스포린 유도체의 합성과 항균력에 관한 연구

박의석,김하정,최원식,황선암 순천향대학교 기초과학연구소 1996 순천향자연과학연구 논문집 Vol.2 No.1

New cephalosporin antibiotics, 7-[(3,4-dihydro-6-methoxycarbonyl-2,2-dimethyl-2H-1,4-thiazin-3-yl 1-oxide) -acetamido]-3-heterocyclothiomethyl-3-cephem-4-carboxylic acid derivatives (2a-2d) were synthesized. Anti-bacterial activities of these new cephalosporin derivatives and the relationship between their stucture and their activities were examined. Among them, 7-[3,4-dihydro-6-methoxycarbonyl-2,2-dimethyl-2H-1,4- thiazin-3-yl1-oxide)acetamido]-3-[(2-methyl-1,3,4-thiadiazol-5-yl)thiomethyl]-3-cephem-4-carboxylic acid exhibited the broad antibacterial activities against Gram(+) and Gram(-) bacteria.

가토에서 Pentoxifylline, Asprin 및 Heparin이 피부피판의 생존 및 출혈 경향에 미치는 영향

하주원,백승,박홍주,오희균,유선열 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.5

The skin flap, which has been frequently used in the maxillofacial soft tissue defects, can be failed due to insufficient blood supply to the flap. To increase its survival rate, antithrombotic agents has been used. The agents have, however, been restrictly used because of their side effects, such as bleeding tendency or hematoma formation on the operation site. The present study aimed to the effect of pentoxifylline, aspirin, and heparin on the skin flap survival rate and bleeding tendency. Twelve adult white rabbits, weighing about 2.0 ㎏, were used. Five random skin flaps, which is 1㎜ thickness, were prepared on the dorsal surface of each rabbit by using 1.5×7.5㎝ prefabricated template. The animals were divided into 4 groups on the basis of drugs used: Control group, animals in which no drug was given (n=3); Pentoxifylline group, animals in which pentoxifylline was given intraorally (n=3); Aspirin group, animals in which aspirin was given intravenously (n=3), and Heparin group, animals in which heparin was given intravenously (n=3). On the 3rd and 7th day after operation, prothrombin time (PT) and activated partial thromboplastin time (aPTT) were measured to evaluate the bleeding tendency. The animals were sacrificed on the 7th day and the mean skin falp survival rate of each group was measured. The results obtained were as follows : The skin flap survival rates of pentoxifylline (84.3±7.9%) and heparin (79.5±10.9%) groups were significantly increased, compared with control group (68.0±10.8%)(P<0.05). The survival rate of aspirin group (73.0±11.1%) was not increased. In bleeding tendency, the PT values were prolonged in heparin and aspirin groups at the 3rd day after operation (P<0.05), and prolonged in order of heparin group, aspirin group, and pentoxifylline group at the 7th day after operation. The aPPT values in heparin and aspirin groups were also prolonged at the 3rd day after operation (P<0.05), and prolonged in order of Aspirin group, Heparin group, and Pentoxifylline group at the 7th day after operation. These results suggest that pentoxifylline may be the most useful drug among three drugs to increase skin falp survival rate and less increase the bleeding tendency.

영동지역 주요 3개 하천의 수질실태 및 관리에 관한 연구

박광하,민선홍,최봉종,전방욱 강릉대학교동해안지역연구소 1994 東海岸硏究 Vol.5 No.1

영동지방의 주요 3개 하천의 수질을 조사하고 QUAL-2E 모델을 적용하여 보았다. 강릉남대천은 각 수질항목에서 시기별, 정점별로 큰 차이를 보였으며, 일반적으로 상류의 수질은 하류로 갈수록 생활오수의 유입으로 수질이 악화되는 전형적인 양상을 나타내었다. 양양남대천은 강릉남대천 및 삼척오십천에 비하여 시기별 변이폭이 좁았으며 각 정점별의 수질도 양호한 것으로 나타났다. 삼척오십천은 시기별보다는 정점별 수질차이가 크게 나타났으며 오염된 상류의 수질이 자정작용에 의하여 개선되다가 다시 생활오수의 유입으로 인하여 악화되는 특이한 양상을 보였다. 모델링 결과 하천의 유속, 유량등의 실측 자료가 부족함에도 불구하고 강릉남대천과 양양남대천은 실측치와 예상치가 높은 상관관계를 나타내었다. 또한 이 모델을 사용하여 강릉남대천의 수질예측을 시도하였다. The water quality was monitored and QUAL-2E modelling was applied in three main stream of Youngdong area. Kangnung Namdaecheon was shown to be a typical stream that the downstream water quality was worse than in the upperstream. Water quality of Yangyang Namdaecheon was better than that of Kangnung Namdaecheon and Samchuk Osipcheon. The spatial variation of water quality was greater than the temporal variation in Samchuk Osipcheon: the polluted upperstream water got better in the midstream, but got worse gain in the downstream. Despite of the lack of suitable measurement data, Kangnung Namdaecheon and Ynagyang Namdaecheon showed good relationship between measured and obtained data: however Samchuk Osipcheon, which had many point sources and much pollution load, showed poor relationship. Based on this model, future water quality of Kangnung Namdaecheon was prospected.

가토에서 Pentoxifylline, Aspirin 및 Heparin이 피부피판의 생존 및 출혈 경향에 미치는 영향

하주원,백승,박홍주,오희균,유선열 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.2

The skin flap, which has been frequently used in the maxillofacial soft tissue defects, can be failed due to insufficient blood supply to the flap. To increase its survival rate, antithrombotic agents has been used. The agents have, however, been restrictly used because of their side effects, such as bleeding tendency or hematoma formation on the operation site. The present study aimed to the effect of pentoxifylline, aspirin, and heparin on the skin flap survival rate and bleeding tendency. Twelve adult white rabbits, weighing about 2.0 kg, were used. Five random skin flaps, which is 1mm thickness, were prepared on the dorsal surface of each rabbit by using 1.5 X 7.5 cm prefabricated template. The animals were divided into 4 groups on the basis of drugs used: Control group, animals in which no drug was given (n=3); Pentoxifylline group, animals in which pentoxifylline was given intraorally (n=3); Aspirin group, animals in which aspirin was given intravenously (n=3). On the 3rd and 7th day after operation, prothrombin time (PT) and activated partial thromboplastin time (aPTT) were measured to evaluate the bleeding tendency. The animals were sacrificed on the 7th day and the mean skin flap survival rate of each group was measured. The results obtained were as follows : 1. The skin flap survival rates of pentoxifylline (84.3±7.9%) and heparin (79.5±10.9%) groups were significantly increased, compared with control group (68.0±10.8%)(ㅔ<0.05). The survival rate of aspirin group (73.0±11.1%) was not increased. 2. In bleeding tendency, the PT values were prolonged in heparin and aspirin groups at the 3rd day after operation (p<0.05), and prolonged in order of heparin group, aspirin group, and pentoxifylline group at the 7th day after operation. The aPPT values in heparin and aspirin groups were also prolonged at the 3rd day after operation (p<0.05), and prolonged in order of Aspirin group. Heparin group, and Pentoxifylline group at the 7th day after operation. These results suggest that pentoxifylline may be the most useful drug among three drugs to increase skin flap survival rate and less increase the bleeding tendency.

R·C 교량의 외관상태에 관한 연구

박길현,황선하 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.1

As the human material life style growth and the industrialization have been taking place, the overland transporting system also has been growing with its size, mass, and velocity. Especially, since domestic overland transporting system is rapidly growing, the smooth function of highway is very important in economic and military matters. To meet these requirements, the bridge's usage, safety, and durability have to be revaluated very carefully. But by focusing only on the quantity of the public basic facility has brought many tragedies to us. To prevent such incidents, there are many steps we can take such as careful planning, careful designing, careful constructing, using good materials, and steady maintenance; the most important thing is the maintenance.Taking all this in consideration, in this thesis ra like to construct a system related to the safety of ferroconcrete bridge according to fuzzyidea, and at the same time creating a scientific maintenance system would be very important to gain credibility from regular citizens.

아질산 노출이 이스라엘잉어 혈장내 아질산 농도 및 간장 약물대사효소에 미치는 영향

박관하,최상훈,김영길,김용호,최선남,김종배 한국환경독성학회 2003 환경독성보건학회지 Vol.18 No.2

Effects of ambient nitrite, N0₂^(-), at 1, 3, 10 and 30 mg/l, on the changes of plasma nitrite/nitrate and on hepatic drug-metabolizing enzyme activity were examined in the juvenile Israeli carp, Cyprinus carpio. When the fish were exposed to 1 and 3 mg/l N0₂^(-), there was an exposure duration-dependent increase in plasma N0₂- over the 96-hr period reaching 6~7 fold excess the ambient concentration, In the fish exposed to 10 mg/l, a plateau concentration of less than 2-fold of the environment was attained in 12 hr. With 30 mg/l, however, the maximal plasma NOf was 41.25 mg/1 at 12 hr followed by a gradual decline. There was a concentration increase in methemoglobin (metHb) level in all N02^(-)-exposed groups and a significant decrease in hematocrit value in 30 mg/l group after 96-hr exposure. Apart from the blunted increase in plasma N0₂^(-) with higher N0₂^(-)(10 and 30 mg/1) exposure, the ratio of plasma N0₃^(-) to N0₂^(-) was significantly higher in these groups compared to 1 and 3 mg/l. The imbalance in the plasma N0₃^(-)/N0₂^(-) at higher N0₂^(-) exposure suggests a possible accelerated conversion of N0₂^(-) to N0₃^(-). Nitrite exposure did not affect the hepatic drug-metabolic activities in juvenile Israeli carp. All these data indicate that disposition of N0₂- differ depending upon exposed concentration and that metHb production may not be the exclusive toxic mechanism in carp

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.