BACKGROUND AND OBJECTIVES: The objective of this study was to evaluate improvement in hearing and changes in the tympanogram according to the types of mastoid pneumatization and the mucosal condition of the Eustachian tube orifice after performing tympanoplasty type 1. MATERIALS AND METHODS: Among the patients with chronic otitis media who had received tympanoplasty type 1 at Asan Medical Center from June 1990 to March 1997, sixty five patients were evaluated with pure tone audiometry and tympanometry for a short-term (<6 months) and long-term (>1 year) follow-up period. RESULTS: Greater improvement in hearing was shown in patients with tympanogram type A as compared to the patients with type B and C in both short-term and long-term follow-ups. Patients who showed normal mastoid pneumatization were found to have type A tympanogram more frequently than patients who showed abnormal mastoid pneumatization. However, the degree of postoperative hearing improvement did not depend on the types of mastoid pneumatization. Mucosal condition of the Eustachian tube orifice had some influence on the outcome of postoperative tympanogram and hearing. Greater improvement in the hearing levels were observed more frequently in the normal mucosa. CONCLUSION: Postoperative improvement in hearing was closely related to the postoperative change in the tympanogram. Postoperative hearing results and tympanograms were mainly influenced by the mucosal condition of the Eustachian tube orifice. Relatively greater improvement in hearing was observed in the long-term follow-up compared to the short-term follow-up. However, in order to reach any conclusion on this matter, a longer follow-up period and closer observation would be required.
Acoustic Impedance Tests ; Audiometry ; Chungcheongnam-do ; Eustachian Tube ; Follow-Up Studies* ; Hearing* ; Humans ; Mastoid ; Mucous Membrane ; Otitis Media ; Tympanoplasty*

Otitis media with effusion(OME) is a very common disease of young children, but adult-on-set otitis media with effusion is rarely considered. A few of factors contribute to pathogenesis of otitis media with effusion, which are poor tubal dysfunction, upper respiratory viral infection, bacterial adherence, and immune status of the host. Otologic complaints are dominant in many of adult-onset OME patients. Sinusitis is the most common causal disease of adult-onset OME in our study. In our study, we conclude that adult-onset OME is a relatively common disease in contrast to the current thought and that we must carefully evaluate upper airway, especially sinuses and nasopharynx, and systemic aspects in adult-onset OME.
Bacterial Infections ; Child ; Humans ; Nasopharynx ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Sinusitis

This study was carried out to assess the present level of atmospheric metals. Five metals-lead, cadmium, chromium, manganese, vanadium-were checked on the industrial(Sasang) and residental area(Daeshindong) in the city of Pusan sampling period was the year of 1986, 1990, and 1994, and the sampling time was 2 days of each site. As the result of comparison with the atmospheric standard of ASHRAE(1980) the average concentrations of lead was above the standard, the average concentrations of chromium was around the standard, and the average concentrations of cadmium and vanadium was below the standard. The average concentrations of manganese was above the standard of industrial environment. And the average concentrations of five metals was higher in the industrial area than the residental area The average concentrations of lead cadmium and chromium showed the increase tendency by the year, and the average concentrations of vanadium showed no change, and the average concentrations of manganese showed the decrease tendency. As a result of correlation analysis, lead and cadmium(r=0.31), vanadium and manganese(r=0.24), vanadium and chromium(r=0.19) showed significance.
Busan* ; Cadmium ; Chromium ; Manganese ; Metals ; Metals, Heavy* ; Vanadium

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
Cefotaxime ; Humans ; Immunization Programs ; Korea ; Levofloxacin ; Multiplex Polymerase Chain Reaction ; Penicillins ; Pneumococcal Vaccines ; Pneumonia ; Serogroup ; Streptococcus pneumoniae ; Streptococcus ; Vaccines

BACKGROUND: This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules (18microgram once daily) with a ipratropium metered dose inhaler (2 puffs of 20microgram q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). METHOD: After the initial screening assessment and a two-week run-in period, patients received either tiotropium 18microgram once daily or ipratropium 40microgram four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. RESULT: In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted FEV1 of 42 (12)% were analyzed. The trough FEV1 response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. CONCLUSION: This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.
Adult* ; Albuterol ; Bronchodilator Agents ; Capsules ; Forced Expiratory Volume ; Humans ; Inhalation ; Ipratropium* ; Lung ; Mass Screening ; Metered Dose Inhalers ; Outcome Assessment (Health Care) ; Peak Expiratory Flow Rate ; Pulmonary Disease, Chronic Obstructive* ; Surveys and Questionnaires ; Vital Capacity ; Tiotropium Bromide