No abstract available.
Animals ; Cadmium Poisoning* ; Cadmium* ; Olfactory Mucosa* ; Rats*

No abstract available.
Child* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in the synovial membrane, periarticular structures, skeletal muscle and perineural sheath. Eventually, the joints are destroyed, ankylosed and deformed. Therfore, the aim of treatment is to keep the inflammatory process at a minimum, thereby preserving the joint motion, maintaining the health of muscle supplying motor power about the joint and preventing secondary joint stiffness and deformity. Surgical treatment in rheumatoid arthritis has progressed and there have been advances in the relief of pain and increase in the range of motion. Among them the results of total knee arthroplasty (TKA) have improved steadily during the past decade due to refinements in design, fixation, and surgical technique. At orthopedic department of seoul national university hospital, we performed 31 total knee replacement in 18 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1988. Following results were obtained. 1. Knee score increased from 37.8 to 76.9. 2. Tibio-femoral angle was corrected from 0.9° valgus to 5.3° valgus. 3. Conplications were peroneal nerve palsy in 3 knees, instability in 1 knee, tuberculous arthritis in 1 knee. 4. In 25 out of 31 knees, good functional results were obtained.
Adult ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Humans ; Joints ; Knee ; Middle Aged ; Muscle, Skeletal ; Orthopedics ; Paralysis ; Peroneal Nerve ; Range of Motion, Articular ; Seoul ; Synovial Membrane

BACKGROUND AND OBJECTIVES: Recurrent vestibulopathy is defined a disease characterized by more than a single episode of vertigo of duration characteristic of endolymphatic hydrops but without auditory or clinical neurological symptoms or signs. To investigate the clinical characteristics and the efficacy of combination therapy, we analyzed the clinical records of the patients diagnosed as recurrent vestibulopathy. MATERIALS AND METHOD: Clinical records of sixty four patients diagnosed as recurrent vestibulopathy were retrospectively reviewed. The data on age, sex distribution, natural history, family history of recurrent vestibulopathy, concurrent headache, caloric response was analyzed. The efficacy of combination therapy for vertigo control in the patients with a minimum 24-month follow-up was also evaluated. RESULTS: Mean onset age of recurrent vestibulopathy was 43 years and there was a female preponderance. Concurrent headache and elevated SP/AP ratio in electrocochleogram was frequently observed in these patients. After the combination medical therapy, patients with severe recurrent vestibulopathy showed significant decrease in the number of vertigo spells with 37.5% of complete control of vertigo. CONCLUSION: As a distinctive clinical disorder with unknown cause, recurrent vestibulopathy should be always considered to the patients complaining recurrent episodic vertigo. Combination therapy individualized to the symptoms and signs of the patients with recurrent vestibulopathy might be effective in reducing the frequency of vertigo attacks. Further case-control studies with large population should be necessary.
Age of Onset ; Case-Control Studies ; Endolymphatic Hydrops ; Female ; Follow-Up Studies ; Headache ; Humans ; Natural History ; Retrospective Studies ; Sex Distribution ; Vertigo ; Vestibular Neuronitis*

The specific aims of this prospective survey were to determine the accuracy of traditional diagnostic tools, such as pneumatic otoscopy, otomicroscopy, and tympanometry, and evaluate the usefulness of myringotomy as a diagnostic method; also to determine the significance of myringotomy in treating otitis media with effusion (OME). The status of middle ear of 51 children (85 ears) from November 2002 to February 2003 was examined using pneumatic otoscopy, otomicroscopy, and tympanometry, and the presence/absence of middle ear effusion was confirmed by myringotomy. The otomicroscopy was the most sensitive and specific one among three diagnostic tools. But, it had some false positive cases. This study failed to show the therapeutic efficacy of myringotomy. Otomicroscopy seems to have the potential to become the standard for diagnosis of OME and for validation of pneumatic otoscopy in children. However, when otoscopic, otomicroscopic findings and tympanogram of suspected ear show poor correlation, myringotomy can be used to confirm the presence of OME, as the diagnostic modality. As the therapeutic modality, we think that it is proper to limit indications of myringotomy to some selected cases.
Child ; Child, Preschool ; False Positive Reactions ; Female ; Humans ; Male ; Middle Ear Ventilation/*standards ; Otitis Media with Effusion/*diagnosis/*therapy ; Otoscopy/*standards ; Prospective Studies ; Reproducibility of Results ; Sensitivity and Specificity ; Treatment Outcome

BACKGROUND AND OBJECTIVES:Prevention of mucosal changes induced by experimental pneumococcal otitis media with antibiotics was reported in the previous studies. But the effects of combined therapy with antibiotics and steroid on middle ear mucosa in acute otitis media is not determined yet. The purpose of this study was to investigate the treatment effects of antibiotics and steroid on the middle ear mucosa of experimental acute otitis media. MATERIALS AND METHOD: The right middle ear of 27 rats was inoculated with log phase type 3 streptococcus pneumoniae, and the left ear served as control. Penicillin G was administered to 9 rats, penicillin G and dexamethasone were administered to 9 rats after bacterial challenge. The animals were killed at day 4, 7 or 14 after challenge. Tympanic membrane and middle ear mucosa were examined under the surgical microscope and light microscope. RESULTS: Untreated pneumococcal AOM has been shown to cause persistent structural changes of the middle ear mucosa. Both in antibiotics-treated group and in antibiotics and steroid-treated group, the structural changes were diminished, as compared with those of untreated infected controls. The antibiotics and steroid-treated group showed marked decrease of structural changes, especially in mucosal metaplasia to secretory epithelium. CONCLUSION: The results suggest that the combination treatment of antibiotics and steroid in acute otitis media would seem to be almost as effective in reducing treatment period and preventing the persistence of mucosal changes, which may decrease development of serous otitis media as a sequale of acute otitis media.
Animals ; Anti-Bacterial Agents* ; Dexamethasone ; Ear ; Ear, Middle* ; Epithelium ; Metaplasia ; Mucous Membrane* ; Otitis Media with Effusion ; Otitis Media* ; Otitis* ; Penicillin G ; Rats* ; Streptococcus pneumoniae ; Tympanic Membrane

BACKGROUND AND OBJECTIVES: It has been known that immune reaction plays important roles in the pathogenesis of otitis media with effusion (OME). However, the immunologic mechanisms of OME have not been well defined yet. We investigated the changes of middle ear mucosal inflammation induced by lipopolysaccharide (LPS) following administration of immunosuppressive agent, Cyclosporin A (CsA) in experimental animals. MATERIALS AND METHOD: 35 mul LPS was injected into the middle ears of 30 rats. These rats were divided into groups of 10, each receiving CsA, Dexamethasone, and no treatment, respectively, daily. Five rats from each group were sacrificed at day 2 and 6 after the injection of LPS. RESULTS: Both the CsA-treated and the steroid-treated groups showed lesser inflammatory changes than the untreated groups, however, there were no significant differences between the CsA-treated and the steroid-treated groups. Both on day 2 & day 6, the CsA-treated group showed a decrease of mucosal metaplasia and secretory epithelium, compared with the untreated and steroid-treated group. CONCLUSION: The results suggest that CsA may be effective in decreasing inflammation with particular significance in mucosal mataplasia and the secretion of effusion in OME.
Rats ; Animals

BACKGROUND AND OBJECTIVES: The animal model of allergic rhinitis is important to study the pathophysiology of allergy and to design an effective treatment for allergic disease. The purpose of this study was to establish the animal model for allergic rhinitis by local sensitization with Dermatophagoides pteronyssinus (Der p), the most common allergen in Korea. We also investigated anti-allergic effect of Bacillus Calmette-Guerin (BCG) in this model. MATERIALS AND METHOD: Six-week-old female BALB/c mice were divided into three groups; an allergic rhinitis group, a BCG group sensitized with Der p by local sensitization for 7 weeks, and a normal control group which received phosphate buffered saline. BCG group received 1 x 1(5) colony-forming units/ml of BCG subcutaneously once in a week for 7 weeks. The mice were examined for nasal allergic symptoms and nasal mucosa eosinophilia. Analyses of serum total IgE level, cytokine pattern and eosinophilia in bronchoalveolar lavage (BAL) were carried out. RESULTS: The results were as follows: Allergic symptoms were more significantly increased in the allergic rhinitis group than in the normal control group (p<0.001), and was more significantly decreased in the BCG group allergic rhinitis group (p<0.001). Eosinophil count in nasal mucosa was more significantly increased in the allergic rhinitis group than in the normal control group (p<0.001), and was more significantly decreased in the BCG group than in the allergic rhinitis group (p<0.001). Serum total IgE was more significantly increased in the allergic rhinitis group (p<0.001) and BCG group (p<0.001) than in the normal control group, andwas not more significantly decreased in the BCG group than in the allergic rhinitis group. Total cells and macrophages, eosinophils, lymphocytes, and neutrophils in the BAL (bronchoalveolar lavage) fluid were significantly increased in the allergic rhinitis group than in the normal control group (p<0.01), and were significantly decreased in the BCG group than in the allergic rhinitis group (p<0.01). The IFN-gamma levels in BAL fluid were more significantly decreased in the allergic rhinitis group than in the normal control group (p<0.001), and were more significantly increased in the BCG group than in the allergic rhinitis group (p=0.019). IL-13 levels in the BAL fluid were more significantly increased in the allergic rhinitis group (p=0.042) and BCG group (p<0.001) than in the normal control group, and was not significantly decreased in the BCG group than in the allergic rhinitis group. CONCLUSION: Our findings suggest that we can design murine allergic rhinitis model for Der p allergen only through local sensitization, and BCG was found to exhibit antiallergic effect in this model.
Animals ; Bacillus ; Bronchoalveolar Lavage ; Dermatophagoides pteronyssinus ; Eosinophilia ; Eosinophils ; Female ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation* ; Interleukin-13 ; Korea ; Lymphocytes ; Macrophages ; Mice* ; Models, Animal ; Mycobacterium bovis* ; Nasal Mucosa ; Neutrophils ; Rhinitis

To evaluate the immunological role in the etiopathogenesis of sudden deafness, sera from 44 patients with sudden sensorineural hearing loss were analyzed by 1) immunologic screening tests such as erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), immunoglobulin(IgG, IgM) levels, complement(C3, C4) levels, autoantibody(rheumatoid factor, anti-DNA antibody, antinuclear antibody) levels, cryoglobulin and FTA-ABS 2) Western blotting immunoassay against cow's inner ear proteins 3) viral marker assay(serum IgG and IgM titer against cytomegalovirus, herpes simplex virus, varicella-zoster virus, measles virus, mumps virus and rubella virus). Thirteen(29.5%) of 44 patients displayed positive responses on immunologic screening tests. Significantly higher incidences of immunological abnormalities were found in the parameters such as levels of IgG, ESR, IgM and anti-nuclear antibody. Of 41 patients whose sera were analyzed by Western blot against fresh bovine inner ear antigen preparation, nobody showed the antibody against 68kD protein, and 1(2.4%), 4(9.8%), and 4(9.8%) had antibody which reacted with 60kD, 50kD and 33-35kD protein. On viral marker assay, 8(44.4%) of 18 patients showed positive IgG titers against herpes simplex virus, cytomegalovirus, varicella-zoster virus, measles virus, mumps virus and rubella virus. But any of 10 patients did not show significant IgM titers against those viruses. Statistical analysis revealed a significant correlation between the results of immunologic screening tests and the age of the patients(p<0.05 by chi-square), but no correlations with other clinical parameters such as sex, bilaterality, initial hearing level, and recovery(p>0.05 by chi-square respectively). There was no correlation between the results of viral marker assay(IgG) and recovery(p>0.05 by chi-square). The results suggest that viral infection may play a role in development and progress of sudden deafness, while the immunologic disorder may not affect the etiopathogenesis of sudden deafness.
Antibodies, Antinuclear ; Biomarkers ; Blood Sedimentation ; Blotting, Western ; Cytomegalovirus ; Ear, Inner ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Herpesvirus 3, Human ; Humans ; Immune System* ; Immunoassay ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Mass Screening ; Measles virus ; Mumps virus ; Rubella ; Rubella virus ; Simplexvirus