Background and Objectives: Hearing thresholds across frequencies must be obtained for hearing aid fitting. Narrow-band noise (NBN) and speech sounds are often used as stimuli in pediatric audiologic assessments to elicit children’s attention due to their wider frequency ranges as compared to pure tones. However, obtaining complete responses across frequency ranges is challenging in pediatric practice. Therefore, we developed a frequency-specific phoneme screening tool, the Mandarin Phoneme Detection Score Sheet, to help clinicians evaluate aided performance in pediatric practice. Subjects and Methods: A total of 30 adults with typical hearing and 30 children aged 3-12 years with hearing loss were recruited. Threshold ranges for the aided detection of Mandarin phonemes and NBN were measured using 95% confidence intervals. A stepwise regression analysis was then performed to identify the Mandarin phonemes that can predict NBN detection performance. Results: The Mandarin Phoneme Detection Score Sheet was developed based on the results of the regression analysis. It was shown that the phonemes /ɤ, a, tɕh/ could predict detection performance at different frequencies. Conclusions The Mandarin Phoneme Detection Score Sheet can allow audiologists and early intervention professionals to determine the benefits of hearing aids for pediatric patients in the early stage of hearing loss conditions.

BACKGROUND/AIMS: To validate the effectiveness of a newly developed light-emitting diode (LED)-narrow band imaging (NBI) system for detecting early malignant tumors in the oral cavity. METHODS: Six men (mean age, 51.5 years) with early oral mucosa lesions were screened using both the conventional white light and LED-NBI systems. RESULTS: Small elevated or ulcerative lesions were found under the white light view, and typical scattered brown spots were identified after shifting to the LED-NBI view for all six patients. Histopathological examination confirmed squamous cell carcinoma. The clinical stage was early malignant lesions (T1), and the patients underwent wide excision for primary cancer. This is the pilot study documenting the utility of a new LED-NBI system as an adjunctive technique to detect early oral cancer using the diagnostic criterion of the presence of typical scattered brown spots in six high-risk patients. CONCLUSIONS: Although large-scale screening programs should be established to further verify the accuracy of this technology, its lower power consumption, lower heat emission, and higher luminous efficiency appear promising for future clinical applications.
Carcinoma, Squamous Cell ; Endoscopy* ; Head and Neck Neoplasms* ; Hot Temperature ; Humans ; Male ; Mass Screening ; Mouth ; Mouth Mucosa ; Mouth Neoplasms ; Narrow Band Imaging* ; Pilot Projects ; Ulcer

Finite element analyses were performed to study effects on stress distribution generated in jaw bone for various shapes of dental implants: plateau type, plateau with small radius of curvature, triangular thread screw type in accordance with ISO regulations and square thread screw filleted with small radius partially. It was found that square thread screw filleted with small radius was more effective on stress distribution than other dental implants used in analyses. Additional analyses were performed on the implant with square thread screw filleted with small radius for verying design parameters, such as the width of thread end, the height of the thread of the implant and load direction, to determine the optimum dimensions of the implant. The highest stress concentration occurred at the region in jaw bone adjacent to the first thread of the implant. The maximum effective stress induced by a 15 degree oblique load of 100 N was twice as high as the maximum effective stress caused by an equal amount of vertical load. Stress distribution was more effective in the case when the width of thread end and the height of thread were p/2 and 0.46p, respectively, where p is the pitch of thread. At last, using tensile force calculated from the possible insert torque without breading bone thread, finite element analysis was performed on the implant to calculate pre-stress when the primary fixation of the implant was operated in jaw bone. The maximum effective stress was 136.8 MPa which proven to be safe.
Bread ; Dental Implants ; Finite Element Analysis ; Jaw ; Radius ; Social Control, Formal ; Torque

Percutaneous transluminal coronary angioplasty with metal stent placement has become a well-developed treatment modality for coronary stenotic lesions. Although infection involving implanted stents is rare, it can, however, occur with high morbidity and mortality. We describe herein a case of an inserted coronary stent that was infected and complicated with recurrent stent thrombosis, pseudoaneurysm formation and severe sepsis. Despite repeated intervention and bypass surgery, the patient died from severe sepsis.
Aneurysm, False ; Angioplasty, Balloon, Coronary ; Humans ; Mortality ; Myocardial Infarction ; Sepsis ; Stents* ; Thrombosis*

OBJECTIVE: We hypothesized that DNA methylation of development-related genes may occur in endometrial cancer (EC)/ovarian cancer (OC) and may be detected in cervical scrapings. METHODS: We tested methylation status by quantitative methylation-specific polymerase chain reaction for 14 genes in DNA pools of endometrial and OC tissues. Tissues of EC/normal endometrium, OC/normal ovary, were verified in training set using cervical scrapings of 10 EC/10 OC patients and 10 controls, and further validated in the testing set using independent cervical scrapings in 30 EC/30 OC patients and 30 controls. We generated cutoff values of methylation index (M-index) from cervical scrapings to distinguish between cancer patients and control. Sensitivity/specificity of DNA methylation biomarkers in detecting EC and OC was calculated. RESULTS: Of 14 genes, 4 (PTGDR, HS3ST2, POU4F3, MAGI2) showed hypermethylation in EC and OC tissues, and were verified in training set. POU4F3 and MAGI2 exhibited hypermethylation in training set were validated in independent cases. The mean M-index of POU4F3 is 78.28 in EC and 20.36 in OC, which are higher than that in controls (6.59; p<0.001 and p=0.100, respectively), and that of MAGI2 is 246.0 in EC and 12.2 in OC, which is significantly higher that than in controls (2.85; p<0.001 and p=0.480, respectively). Sensitivity and specificity of POU4F3/MAGI2 were 83%–90% and 69%–75% for detection of EC, and 61% and 62%–69% for the detection of OC. CONCLUSION: The findings demonstrate the potential of EC/OC detection through testing for DNA methylation in cervical scrapings.
Biomarkers ; DNA Methylation ; DNA ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Methylation ; Ovarian Neoplasms ; Ovary ; Polymerase Chain Reaction ; Sensitivity and Specificity

BACKGROUND: Extracellular vesicles (EVs) are derived from internal cellular compartments, and have potential as a diagnostic and therapeutic tool in degenerative disease associated with aging. Mesenchymal stem cells (MSCs) have become a promising tool for functional EVs production. This study investigated the efficacy of EVs and its effect on differentiation capacity. METHODS: The characteristics of MSCs were evaluated by flow cytometry and stem cell differentiation analysis, and a production mode of functional EVs was scaled from MSCs. The concentration and size of EVs were quantitated by Nanoparticle Tracking Analysis (NTA). Western blot analysis was used to assess the protein expression of exosomespecific markers. The effects of MSC-derived EVs were assessed by chondrogenic and adipogenic differentiation analyses and histological observation. RESULTS The range of the particle size of adipose-derived stem cells (ADSCs)- and Wharton’s jelly -MSCs-derived EVs were from 130 to 150 nm as measured by NTA, which showed positive expression of exosomal markers. The chondrogenic induction ability was weakened in the absence of EVs in vitro. Interestingly, after EV administration, type II collagen, a major component in the cartilage extracellular matrix, was upregulated compared to the EV-free condition.Moreover, EVs decreased the lipid accumulation rate during adipogenic induction.

No abstract available.
Lower Extremity* ; Lymph Nodes* ; Lymphedema*

Subclavian artery (SCA) perforation is a rare complication while performing SCA intervention. In our present report, a 73-year-old female, with stenosis of the left SCA and situs inversus, presented with exercise-induced left arm weakness. The SCA stenosis was treated with direct stenting with a balloon-expansible Express LD 10×25 mm stent. However, it caused iatrogenic SCA perforation and hemothorax. The perforation was sealed by endovascular repair with operator-modified Endurant II graft stent, which complicated with occlusion of left common carotid artery. And, the carotid artery was rescued by another stent. The graft stent, which was originally designed for abdominal aortic aneurysm, can be modified to suitable length and take as a rescue stent of large vessel with iatrogenic perforation. Due to strong radial force of graft stent, preservation of large side branches should been watched out.
Aged ; Aortic Aneurysm, Abdominal ; Arm ; Carotid Arteries ; Carotid Artery, Common ; Constriction, Pathologic ; Female ; Hemothorax ; Humans ; Situs Inversus ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome ; Transplants*

INTRODUCTION: Cathepsin D (CD) is a lysosomal protease that can be used as an important prognostic cytosolic factor for breast cancer. Its over-expression in breast cancer cells and in the host stromal cells in the tumor has been proposed as being a poor prognostic indicator. However, its prognostic value is still being debated. Therefore, CD expression needs to be examined in more relevant subsets of tissue in order to refine its prognostic significance and the clinical applications. METHODS: Regardless of the lymph node status, 110 T1 invasive ductal carcinomas of the breast were immunohistochemically evaluated for the CD expression using rabbit anti-cathepsin D monoclonal antibody. This study separately assessed the expression of CD in the invasive component (IDC), in the in situ component (DCIS), and in the juxtatumoral stromal cells (JTSC). The CD expression level in these three kinds of tissues were correlated with the nuclear grade, ER, PR, c-erb-B2, p53, the N stage, the T stage, and the 5 year metastasis-free survival. RESULTS: Positive CD expression in the JTSC was associated with the T stage (p = 0.001) and the N stage (p = 0.029), whereas positive CD expression in the DCIS and IDC was not. In addition, strong CD expression in the JTSC correlated with the nuclear grade of the invasive component (p = 0.024). In all three components, no statistically significant correlation was found between the biomarker (ER, PR, cerb-B2, p53) and the CD expression. On univariate analysis, positive expression in the JTSC was correlated with a poor 5 year- metastasis free survival (p = 0.007), but the positive expression in the IDC and DCIS was not. CONCLUSION: CD expression of the JTSC could represent the N stage, the T stage, and the nuclear grade of T1 IDC. Whether or not it would have an independent influence on the prognosis of T1 IDC, CD expression in the JTSC is probably an indicator of the tumor virulence. CD expression in the JTSC will provide an important clue for the development of new CD targeted therapies, and it will serve as an important criterion for selecting the appropriate candidates for these future targeted therapies.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating ; Cathepsin D* ; Cathepsins* ; Cytosol ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stromal Cells* ; Virulence

BACKGROUNDAcupuncture has been shown to be effective in pain relief and anesthesia, and has been suggested for treating various kinds of functional disabilities in traditional Chinese medicine, including knee osteoarthritis (OA). The study aimed to investigate the immediate effects of acupuncture on gait patterns in patients with knee OA.

METHODSTwenty patients with bilateral medial knee OA were assigned evenly and randomly to a sham group and an experimental group. During the experiment, the experimental group underwent a 30-minute formula electro-acupuncture treatment while the sham group received a sham treatment. Before and after treatment, each subject was evaluated for their knee pain using visual analog scales (VAS) and then their performance of level walking using gait analysis. For all the obtained variables, the independent t-test was used for between-group comparisons, while paired t-test was used to investigate the before and after changes.

RESULTSAll the measured data before acupuncture treatment between the groups were not significantly different. The VAS scores were decreased significantly after acupuncture in both groups, and the mean change of the VAS values of the experiment group was 2 times greater than that of the sham group. After formula acupuncture stimulation, while no significant changes were found in all the gait variables in the sham group, the experimental group had significant increases in the gait speed, step length, as well as in several components of the joint angles and moments.

CONCLUSIONSThe results of the study suggest that significantly improved gait performance in the experimental group may be associated with pain relief after treatment, but the relatively small decrease of pain in the sham group was not enough to induce significant improvements in gait patterns. Gait analysis combined with the VAS can be useful for the evaluation of the effect of acupuncture treatment for patients with neuromusculoskeletal diseases and movement disorder.

Acupuncture Therapy ; Aged ; Biomechanical Phenomena ; Female ; Gait ; physiology ; Humans ; Male ; Middle Aged ; Models, Biological ; Osteoarthritis, Knee ; therapy ; Treatment Outcome