Background and Objectives: Auditory training involves active listening to auditory stimuli, and it has garnered attention in recent years because it enhances speech-in-noise recognition and the satisfaction of hearing aids. The purpose of this study was to determine the efficacy of a closed-set auditory training protocol for adult hearing aid users. We also evaluated the retention effect of training at a 1-month follow-up test after the completion of training. Subjects and Methods: Twenty-two hearing-impaired listeners who have used bilateral hearing aids for more than two months participated in this study. Out of 22 participants, 12 participants (training group, TG) received an 8-week auditory training while 10 participants did not receive any training (non-training group, NTG). For training, three types of closed-set training materials (environmental sounds, words, and sentences) were used. The training was conducted eight times over eight weeks (one session per week, about one hour per session). The difficulty level was adjusted by controlling the number of closed-set choices and the signal-to-noise ratios. To determine the efficacy of training, open-set speech recognition abilities and subjective hearing aid satisfaction were evaluated. Results: All the open-set speech recognition performances of the TG were enhanced after the closed-set auditory training, while the performance of the NTG was not significantly changed. The auditory training had a positive impact on the TG individuals’ subjective satisfaction of hearing aids. The improvement from training was maintained over one month after the completion of the auditory training. Conclusion The closed-set auditory training protocol might lead to enhanced speech understanding as well as more satisfaction with hearing aids for adult hearing aid users.

30 cases of methemoglobinemia who had been admitted in pediatric department of Busan National University Hospital from Jan. 1970 to Jun. 1976 were clinically studied, and the results were summerized as followings: 1. The incidence of methemoglobinemia was corresponding to 0.5% of all pediatric in patients, and 16.7% of all acute poisoning during same period. 2. The sex ratio of male to female was 2:1 and the peak age group was 1 to 3 years of age. 3. The prevalent incidence in a year was shown in August and in Summer season. 4. The most frequent causative substances of methemoglobinemia was D.D.S(26 cases) and then phenacetine( 2 cases). The motive of poisoning was mianly accidental causes(23 cases) 5. Clinical features of methemoglobinemia was relatively good and this patient was treated with methylene blue and ascorbic acid.
Ascorbic Acid ; Busan ; Child* ; Female ; Humans ; Incidence ; Male ; Methemoglobinemia* ; Methylene Blue ; Poisoning ; Seasons ; Sex Ratio

PURPOSE: . This study aims to evaluate the effects of exposure energy on the lateral resolution and mechanical strength of dental zirconia manufactured using digital light processing (DLP). MATERIALS AND METHODS: . A zirconia suspension and a custom top-down DLP printer were used for in-office manufacturing. The viscosity of the suspension and uniformity of the exposed light intensity were controlled. Based on the exposure energy dose delivered to each layer, the specimens were classified into three groups: low-energy (LE), medium-energy (ME), and high-energy (HE). For each energy group, a simplified molar cube was used to measure the widths of the outline (Xo and Yo ) and isthmus (Xi and Yi ), and a bar-shaped specimen of the sintered body was tested. A Kruskal–Wallis test for the lateral resolution and one-way analysis of variance for the mechanical strength were performed (α = .05). RESULTS: . The zirconia green bodies of the ME group showed better lateral resolution than those of the LE and HE groups (both P < .001). Regarding the flexural strength of the sintered bodies, the ME group had the highest mean value, whereas the LE group had the lowest mean value (both P < .05). The ME group exhibited fewer agglomerates than the LE group, with no distinctive interlayer pores or surface defects. CONCLUSION . Based on these findings, the lateral resolution of the green body and flexural strength of the sintered body of dental zirconia could be affected by the exposure energy dose during DLP. The exposure energy should be optimized when fabricating DLPbased dental zirconia.

Cesarean hysterectomy is associated with high risks of severe blood loss, postoperative complication, and maternal morbidity. This study was undertaken to identify the risk factors of cesarean hysterectomy and to reduce the postoperative complications and maternal morbidity. There were 6,362 deliveries between January 1992 and December 1996 at department of obstetrics and gynecology, Inchon Christian Hospital. 1'he results of this study were as follows, 15 cases of cesarean hysterectomy were performed during this period. Cesarean hysterectomy was performed in 10 cases (0.32 %) among 3178 cesarean deliveries and in 5 cases (0.16 %) among 3184 vaginal deliveries. The incidence of cesarean hysterectomy was 0.24 % (15/6,362). The age of patients ranged from 24 to 38 years old. The maternal mortality and morbidity were 0 % (0/15) and 86.7% (13/15), respectively. Indications for cesarean hysterectomy were uterine atony (53.3 %), uterine myoma with pregnancy (20.0 %), placenta accreta and/or increta(20.0 %), and placenta previa (6.7 %) in orders. The associated risk factors of cesarean hysterectomy were prior cesarean delivery (46.7 %) and placenta previa (6.7 %). The postoperative complications were anemia (60.0%), febrile morbidity (13.3 %), paralytic ileus (6.7 %), and wound disruption (6.7 %). We concluded that risk factors of cesarean hysterectomy were cesarean delivery, prior cesarean delivery, uterine myoma with pregnancy, placenta accreta and/or increta, and placenta previa and that sufficient fresh blood and careful prenatal care were needed in risk group of postpartum bleeding.
Adult ; Anemia ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Intestinal Pseudo-Obstruction ; Leiomyoma ; Maternal Mortality ; Obstetrics ; Placenta Accreta ; Placenta Previa ; Postoperative Complications ; Postoperative Hemorrhage ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Uterine Inertia ; Wounds and Injuries

This is the case of a 71 year old male who developed multiple myeloma (MM) and chronic myelogenous leukemia (CML) within a two year period. The patient initially presented with osteolytic lesions of the lumbar spine, and following the initial work-up a diagnosis of multiple myeloma with an IgG kappa paraproteinemia was made and appropriate treatment was given. Two years later the patient developed a progressively worsening leukocytosis which was found to be due to Philadelphia Chromosome (Ph1) positive CML. The occurrence in the same patient of two distinct hematologic malignancies suggests a neoplastic transformation of a pluripotent stem cell. A review of the literature appears to support the existence of a relationship between MM and CML as well as a relationship between MM and the myeloproliferative disorders.
Aged ; Case Report ; Cell Transformation, Neoplastic/pathology ; Hematopoietic Stem Cells/pathology ; Human ; Leukemia, Myeloid, Chronic/*pathology ; Male ; Multiple Myeloma/*pathology

PURPOSE: Interleukin-4(IL-4) is a critical component of the Th2 cytokine pathway and contributes to severity of respiratory syncytial virus(RSV) bronchiolitis. Previous studies observed an association between severe RSV bronchiolitis in Korean children with a common haplotype of the IL4 promoter. This study was performed to investigate functional differences of the variant IL4 promoter haplotypes. METHODS: Genomic DNA was obtained from 20 children from 6 to 48 months of age in the Department of Pediatrics, Seoul National University Bundang Hospital. The IL4 promoter spanning an 1.2 kb region was amplified and haplotype was determined by cloning and the PHASE reconstruction. Transcriptional activity of Jurkat T cells which were transfected with each IL4 haplotype were analyzed by use of luciferase assay. RESULTS: Three haplotypes of the IL4 promoter have been identified with the frequency of GCC(7 percent), TCC(17 percent), and TTT(76 percent). The TTT haplotype demonstrated the highest luciferase values in both unstimulated and PMA-stimulated Jurkat T cells. Increases in transcriptional activity compared to GCC have been shown in TTT(5.3 fold higher) followed by TCC(4.2 fold higher) in unstimulated Jurkat T cells. CONCLUSION: We provided evidence that increased transcriptional activity of the TTT haplotype of the IL4 promoter, which has previously been over-represented in Korean children with severe RSV bronchiolitis. Therefore, IL-4 could play a potential role in the pathogenesis of RSV infection, possibly via an altered transcriptional activity of the different IL4 haplotypes.
Bronchiolitis ; Child ; Clone Cells ; Cloning, Organism ; DNA ; Haplotypes* ; Humans ; Interleukin-4* ; Luciferases ; Pediatrics ; Respiratory Syncytial Viruses ; Seoul ; T-Lymphocytes ; Transcriptional Activation

OBJECTIVE: Cerebral vessels, such as intracerebral perforating arterioles isolated from rat brain, have been widely used as an ex vivo model to study the cerebrovascular function associated with cerebrovascular disorders and the therapeutic effects of various pharmacological agents. These perforating arterioles, however, have demonstrated differences in the vascular architecture and reactivity compared with a larger leptomeningeal artery which has been commonly implicated in cerebrovascular disease. In this study, therefore, we developed the method for studying cerebrovascular function utilizing the olfactory artery isolated from the mouse brain. METHODS: The olfactory artery (OA) was isolated from the C57/BL6 wild-type mouse brain. After removing connective tissues, one side of the isolated vessel segment (approximately -500 microm in length) was cannulated and the opposite end of the vessel was completely sealed while being viewed with an inverted microscope. After verifying the absence of pressure leakage, we examined the vascular reactivity to various vasoactive agents under the fixed intravascular pressure (60 mm Hg). RESULTS: We found that the isolated mouse OAs were able to constrict in response to vasoconstrictors, including KCl, phenylephrine, endothelin-1, and prostaglandin PGH2. Moreover, this isolated vessel demonstrated vasodilation in a dose-dependent manner when vasodilatory agents, acetylcholine and bradykinin, were applied. CONCLUSION: Our findings suggest that the isolated olfactory artery would provide as a useful ex vivo model to study the molecular and cellular mechanisms of vascular function underlying cerebrovascular disorders and the direct effects of such disease-modifying pathways on cerebrovascular function utilizing pharmacological agents and genetically modified mouse models.
Animals ; Arteries* ; Arterioles ; Bradykinin ; Brain ; Cerebral Arteries ; Cerebrovascular Disorders ; Cholinergic Agents ; Connective Tissue ; Endothelin-1 ; Mice* ; Phenylephrine ; Prostaglandin H2 ; Rats ; Vasoconstriction ; Vasoconstrictor Agents ; Vasodilation

PURPOSE: Competency in physical assessment is an important component of nursing practice. However, some physical assessment skills are not being utilized within the current teacher-centered, content-heavy curriculum. This study was conducted to identify the effects of student-centered, self-directed learning in the physical assessment class. METHODS: An experimental study with a post-test only control group design was used to compare an intervention group that was provided self-directed learning classes and a control group that was provided traditional lecture and practice classes. Competency in physical assessment, academic self-confidence, and learning satisfaction were evaluated. Collected data were analyzed using χ²-test (Fisher's exact test) and independent t-test. RESULTS: Competency in physical assessment was significantly higher in the experimental group. However, academic self-confidence and learning satisfaction were not significantly different between the groups. CONCLUSION: The findings in this study indicate that self-directed learning can improve nursing students competency in physical assessment and that self-directed learning is a good education method to improve nursing students' competency in physical assessment during clinical practice and perform quality patient care by making active use of physical assessment skills.
Curriculum ; Education ; Education, Nursing ; Humans ; Learning* ; Methods ; Nursing* ; Patient Care ; Physical Examination ; Students, Nursing*

Background: Hypoxia damages the bladder wall and contributes to the initiation of bladder dysfunction. The change of hypoxia is not well known in impaired bladder contractility caused by long-term bladder outlet obstruction (BOO). We aimed to find out whether hypoxia of bladder tissue is present and what signaling mechanisms are involved in the decompensated bladder in BOO. Methods: Twenty 6-week-old female Sprague-Dawley rats were divided into 2 groups, 10 rats each: group 1, sham operation; group 2, BOO for 8 weeks. Eight weeks after the onset of BOO, we did cystometric evaluation and processed polymerase chain reaction (PCR) array for hypoxia pathway using bladder tissues. The PCR array consists of 84 genes known to be involved in the hypoxic response, cell differentiation, and metabolism. We did quantitative PCR (qPCR) and immunohistochemical staining of bladder tissue for hypoxia. Results: Eight genes were at least 2-fold upregulated and 3 genes were at least 2-fold downregulated in BOO group, compared with the sham operation group. The up-regulated genes (fold change) belonging to the hypoxia-inducible factor (HIF) 1 interactor included Cdkn2a (11.0), and the down-regulated genes belonging to HIF and co-transcription factors included Hif3a (−39.6) and Per1 (−5.1) by BOO. Genes influenced each other by means of TGFβ1, TNF, and TP53. Conclusion Hypoxia genes were increased in impaired contractility because of long-term BOO. The gene expression profiles could explain the molecular mechanisms of hypoxia in impaired contractility because of long-term BOO.

Objectives: Restricted and repetitive behaviors (RRBs) are a core symptom in the diagnosis of autism spectrum disorder (ASD). The complexity of behavioral patterns has called for the creation of phenotypically homogeneous subgroups among individuals with ASD.The purpose of this study was 1) to investigate the different types of RRBs and 2) to explore whether subgroups created by RRBs would show unique levels of functioning in toddlers and young children with ASD. Methods: A total of 313 children with ASD, aged 12–42 months were included in the analysis. The Autism Diagnostic Interview-Revised was used to obtain information on the different types of RRBs by grouping 15 items into six categories. The Vineland Adaptive Behaviors Scale, a parent-reported questionnaire, was used to measure adaptive functioning. A portion of the children were analyzed separately for verbal-related RRBs based on their expressive language level. Two-step cluster analysis using RRB groups as features was used to create subgroups. Analysis of covariance while covarying for age and language was performed to explore the clinical characteristics of each cluster group. Results: Sensory-related RRBs were the most prevalent, followed by circumscribed interests, interest in objects, resistance to change, and repetitive body movements. A subset of the children was analyzed separately to explore verbal-related RRBs. Four cluster groups were created based on reported RRBs, with multiple RRBs demonstrating significant delays in adaptive functioning. Conclusion Heterogeneity of RRBs emerges at a young age. The different patterns of RRBs can be used as valuable information to determine developmental trajectories with better implications for treatment approaches.