The threat of pandemic influenza has focused attention and resources on virus surveillance, prevention, and containment. The World Health Organization has strongly recommended the use of the antiviral drug, Oseltamivir (Tamiflu(R)), to treat and prevent pandemic influenza infection. In recent years, there have been case reports of vestibulocochlear events during or after oseltamivir treatment, other countries. Oseltamivir is generally well-tolerated and its most frequent adverse effects include nausea and vomiting, diarrhea, and abdominal pain. Up to now, bilateral vestibular hypofunction after oseltamivir medication has not been reported. Herein, we report a very rare case of a 36-year-old female with bilateral vestibular hypofunction following oseltamivir medication.
Abdominal Pain ; Containment of Biohazards ; Diarrhea ; Drug Toxicity ; Female ; Humans ; Influenza, Human ; Nausea ; Oseltamivir ; Pandemics ; Vestibular Function Tests ; Viruses ; Vomiting ; World Health Organization

Bilateral sudden sensorineural hearing loss (SSNHL) is rare and usually indicates a serious systemic pathology. We describe an unusual case of bilateral SSNHL caused by sepsis. A 28-year-old female complained of acute-onset bilateral hearing impairment; in addition to otological symptoms, she had a systemic condition that met the criteria for sepsis. We performed a physical examination and laboratory tests to diagnose sepsis. Pure tone audiogram and videonystagmography were performed to evaluate the otological symptoms. Intravenous antibiotics and high-dose methylprednisolone were prescribed for treatment, and audiogram was repeated during that period. The fever subsided and the vital signs were stabilized. The electrolyte imbalance and abnormal urine parameters became normal. Hearing gradually recovered to a normal level on day 7 of hospitalization. In conclusion, sepsis should be considered as a cause of SSNHL. When conducting a detailed examination of patients with bilateral SSNHL, the clinician should consider systemic disease.

PURPOSE: The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. METHODS: One-group, time series, quasi-experimental design with a pre-test and two post-tests was used. Data were collected from cognitively impaired home residents (N=32) and nursing staff (N=36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. RESULTS: Incidence of aggressive behavior was high with a mean score of 3.09 (SD=3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F=2.925, p=.066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.001). CONCLUSION: Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.
Nursing Staff/*education ; *Nursing Homes ; Middle Aged ; Male ; Korea ; *Inservice Training ; Humans ; Female ; Dementia/*nursing/psychology ; Cognition Disorders/*nursing/psychology ; Analysis of Variance ; *Aggression/psychology ; Aged, 80 and over ; Aged ; Adult

Herpes zoster oticus (HZO) is characterized by auricular vesicles, facial palsy and vestibulocochlear dysfunction. The 8th cranial nerve can be most frequently involved. Rarely, it may be associated with the involvement of 5th, 6th, 9th, 11th or 12th cranial nerve. However, only few cases of HZO involving vestibular nerve without facial nerve palsy have been previously reported. We experienced an unusual case of 38-year-old woman who presented with auricular vesicles, otalgia, and vertigo of whilrling nature but not with facial palsy. Vestibular evoked myogenic potential (VEMP) and caloric tests that were performed to determine which division of vestibular nerve was involved demonstrated that decreased responses in this case. We report a case of HZO involving superior and inferior vestibular nerve without facial palsy that was confirmed by VEMP and caloric tests with a review of literature.
Adult ; Caloric Tests ; Cranial Nerves ; Earache ; Facial Nerve ; Facial Paralysis ; Female ; Herpes Zoster ; Herpes Zoster Oticus ; Humans ; Paralysis ; Vertigo ; Vestibular Nerve

PURPOSE: Periostin was originally identified as a secreted factor during screening of a mouse osteoblastic library. In a recent study, periostin was found to directly regulate eosinophil accumulation in allergic mucosal inflammation. Chronic eosinophilic inflammation is related to the development of remodeling. The present study examined the expression of periostin and evaluated its role in the inflammatory process and remodeling associated with allergic rhinitis. METHODS: A murine model of allergic rhinitis was established in periostin knockout mice. We analyzed the expression of periostin, manifestation of nasal symptoms, eosinophilic inflammation, and subepithelial fibrosis as well as the expression of MMP-2, TIMP-1, and type 1 collagen in nasal tissue. RESULTS: Periostin was mainly distributed in the subepithelial tissue of the nasal mucosa. The subepithelial tissue was thinner in the knockout group than in the control group. No differences in the expression of MMP-2 or TIMP-1 were found in the knockout group. However, after a month of allergen challenge, type I collagen in the nasal tissue was lower in the knockout group than in the control group. The number of eosinophils and the symptom score were also lower in the knockout group. CONCLUSIONS: Periostin is expressed in nasal tissues of murine models of allergic rhinitis. Periostin deficiency may affect the remodeling of nasal tissue with reduced subepithelial fibrosis, and lead to less eosinophilic inflammation.
Airway Remodeling ; Animals ; Collagen Type I ; Eosinophils ; Fibrosis ; Hypersensitivity ; Inflammation ; Mass Screening ; Mice ; Mice, Knockout ; Nasal Mucosa ; Osteoblasts ; Rhinitis ; Rhinitis, Allergic, Perennial ; Tissue Inhibitor of Metalloproteinase-1

We have reported RPS-Vax system by introducing multiple cloning site (MCS) and 3C-protease cutting site at the N-terminal end of the poliovirus Sabin 1 cDNA. Potential vaccine genes can be easily introduced into recombinant polioviral genome and expressed during the viral replication as a part of virus polyprotein and subsequently processed from the mature viral protein by the poliovirus-specific 3C-protease. However, these poliovirus vector-mediated chimeric viral vaccine was not efficient to induce the cell-mediated immunity because of its rapid cytolytic capacity. In order to make CTL-inducing vaccine vector, we integrated a protein transduction domain (PTD) into the pRPS-Vax vector system right ahead of the MCS, named RPS-Vax/PTD. We have incorporated the HCV core (N-terminal 100aa) antigen into the MCS of pRPSvax-PTD vector, followed by production of chimeric virus, named RPSvax-PTD/HCVc. The chimeric virus was genetically stable during the serial passages. Replication capacity of the RPSvax-PTD/HCVc was 1~2 log lower than that of RPS-Vax control virus. These chimeric virus was very efficient to inducing antigen-specific IgG2a in the immunized mice, implying that the recombinant virus has a capacity to induce HCV-specific Th1 type immunity in the immunized animals or humans.
Animals ; Clone Cells ; Cloning, Organism ; DNA, Complementary ; Genome ; Hepatitis C* ; Hepatitis* ; Humans ; Immunity, Cellular ; Immunoglobulin G ; Mice ; Poliovirus ; Serial Passage

We have reported RPS-Vax system by introducing multiple cloning site (MCS) and 3C-protease cutting site at the N-terminal end of the poliovirus Sabin 1 cDNA. Potential vaccine genes can be easily introduced into recombinant polioviral genome and expressed during the viral replication as a part of virus polyprotein and subsequently processed from the mature viral protein by the poliovirus-specific 3C-protease. However, these poliovirus vector-mediated chimeric viral vaccine was not efficient to induce the cell-mediated immunity because of its rapid cytolytic capacity. In order to make CTL-inducing vaccine vector, we integrated a protein transduction domain (PTD) into the pRPS-Vax vector system right ahead of the MCS, named RPS-Vax/PTD. We have incorporated the HCV core (N-terminal 100aa) antigen into the MCS of pRPSvax-PTD vector, followed by production of chimeric virus, named RPSvax-PTD/HCVc. The chimeric virus was genetically stable during the serial passages. Replication capacity of the RPSvax-PTD/HCVc was 1~2 log lower than that of RPS-Vax control virus. These chimeric virus was very efficient to inducing antigen-specific IgG2a in the immunized mice, implying that the recombinant virus has a capacity to induce HCV-specific Th1 type immunity in the immunized animals or humans.
Animals ; Clone Cells ; Cloning, Organism ; DNA, Complementary ; Genome ; Hepatitis C* ; Hepatitis* ; Humans ; Immunity, Cellular ; Immunoglobulin G ; Mice ; Poliovirus ; Serial Passage

PURPOSE: This study was done to provide data for a nursing intervention to alleviate newborn pain clinically by investigating the effect of oral glucose. METHODS: Subjects were newborns hospitalized in the nursery. Informed consent was obtained from parents of 60 newborns. A heel stick was carried out for a test on 3 groups; the experimental, placebo, and control group. The Neonatal infant pain scale(NIPS), respiration rate, heart rate, peripheral oxygen partial pressure(SpO2), and crying duration were measured to assess pain reaction. All neonatal behaviors were recorded on videotape. RESULTS: There were significant differences in pain behavior during stimulus(F=4.195, p=.020), pain behavior immediately after blood-sampling (F=4.114, p=.021), and pain behavior 3 minutes after that (F=3.630, p=.033). However, there were no significant differences in heart rate, respiration rate, peripheral oxygen partial pressure or crying duration after the heel stick among the groups. CONCLUSIONS: Oral administration of glucose before a heel stick caused the reduction of neonatal pain behavior, which means that it has an effect of pain relief.
Administration, Oral ; Blood Specimen Collection ; Female ; Glucose/administration & dosage/*therapeutic use ; Heart Rate ; Heel ; Humans ; Infant, Newborn ; Male ; Neonatal Nursing/*methods ; Oximetry ; Pain/nursing/*prevention & control ; Pain Measurement ; Placebos ; Punctures/adverse effects ; Respiration ; Time Factors

BACKGROUND AND OBJECTIVES: Many patients experience middle ear surgery via retroauricular approach. While not a main interest of the surgery, the change of the auricular shape after surgery has been a subject of complaint by some patients. In this study, we wanted to determine if a change in the auricular shape occurs after middle ear surgery and evaluate the possibility of using reconstruction of posterior auricular muscle as a treatment option for this kind of change. SUBJECTS AND METHOD: Forth patients who received middle ear surgery were enrolled in this study. Retroauricular incision and canal up mastoidectomy were carried out to all patients. The patients were separated into two groups randomly before surgery: one group that had the reconstruction of posterior auricular muscle during surgery, and the other that did not. The average of heights of the helix was compared. Also, patients were asked to fill out a questionnaire about auricular shape before and after surgery. RESULTS: The heights of helix increased about 1.6 mm after surgery; however, the difference of increment as a result of reconstruction of posterior auricular muscle was not statistically significant. Questionnaire about the change of auricular shape after surgery showed that only 8% patients had noticed about the change of auricular shape after surgery. CONCLUSION: Most patients have no complaint about auricular shape after middle ear surgery via retroauricular approach. The average of heights of the helix increases after middle ear surgery. However, the reconstruction of the posterior auricular muscle is not effective for reducing the observed increment of heights of the helix following middle ear surgery via retroauricular approach.
Ear Auricle ; Ear, Middle* ; Humans ; Methods

BACKGROUND AND OBJECTIVES Vestibular neuritis (VN) is one of critical life events that can affect physical, emotional, and function aspects of quality of life. Most patients recover well from VN within 6 months following the onset of the disease. However, they can still interfere with their daily lives in some patient with VN. Dizziness Handicap Inventory (DHI) was developed to assess the self-perceived handicapping effects imposed by vestibular system diseases. The aim of study was to evaluate subjective symptoms among the pre-VN, at the time of onset of VN, and post-VN using DHI questionnaire, respectively. MATERIALS AND METHODS Twenty patients with VN were asked to complete the DHI by mailed survey. Each of the DHI was scored. We also evaluated the relationship between the DHI scores and degree of the canal paresis on the caloric test. RESULTS Almost every patients had substantially improved its subjective symptoms in 6 months after VN. There was no correlation between the canal paresis in the lesion ear and DHI scores at the time of VN. CONCLUSION The results of this study suggest that most patients recovery well from VN without any handicap, but the emotional support in combination with physical and/or functional rehabilitation should be required to provide early resumption of normal activity
Dizziness ; Ear ; Humans ; Paresis ; Postal Service ; Quality of Life ; Surveys and Questionnaires ; Vertigo ; Vestibular Neuronitis