Adolescent ; Adult ; Ankle Injuries ; Ankle Joint ; diagnostic imaging ; Female ; Humans ; Ligaments, Articular ; diagnostic imaging ; injuries ; Male ; Middle Aged ; Radiography ; Rupture

Background: Pure tone audiometry is routinely used to determine conductive and sensorineural hearing status. Ossicular discontinuity is usually assessed intra-operatively. If ossicular discontinuity can be predicted by pure tone audiometry, perhaps the operative procedure of choice and prognosis for hearing can also be anticipated. Objective: To determine the predictive value of preoperative pure tone audiometry on the presence of gross ossicular discontinuity in chronic otitis media. Methods: Records of 205 patients, 7 to 75 years of age undergoing their first operation for chronic otitis media were reviewed. Preoperative audiograms and operative records for tympanomastoidectomy were evaluated. A total of 162 patients meeting inclusion criteria were included in the study. Likelihood ratios for positive and negative ossicular discontinuity for frequency-specific air-bone gap cut-offs were determined. Multiple logistic regression analysis for pure tone audiometry and operative findings to predict ossicular discontinuity was performed and a model for predicting ossicular discontinuity using logistic regression obtained. Results and Conclusion: Frequency-specific air bone gap (ABG) cut-off values can predict ossicular discontinuity in chronic suppurative otitis media namely: < 20 dB ABG at 500 Hz predicts absence of ossicular discontinuity while > 50 dB ABG at 500 Hz, >30 dB ABG at 2 KHz, and > 50 dB ABG at 4 KHz best predict the presence of ossicular discontinuity in general. In the absence of cholesteatoma, the air bone gaps of <30 dB at 500 Hz and <20 dB at 1 KHz decrease probability of ossicular discontinuity from 32.97 percent to 2.54 percent. Combination of air bone gaps of >50 dB at 500 Hz, >20 dB at 2 KHz and >40 dB at 4 KHz increase the probability of ossicular discontinuity from 32.97 percent to 85.9 percent. These findings suggest that ossicular exploration may not be necessary for the former while an evaluation of the ossicular chain may be mandatory for the latter in the setting where cholesteatoma is not present or suspected. Presence of cholesteatoma, granulation tissue and size of tympanic membrane perforation are important factors to consider in predicting ossicular discontinuity. (Author)
AUDIOMETRY AUDIOMETRY ; PURE-TONE OTITIS MEDIA OTITIS MEDIA ; SUPPURATIVE LOGISTIC MODELS HEARING TESTS SUPPURATION

OBJECTIVES:To determine the agreement between 1) ear examination findings of the otorhinolaryngologist using an otoscope and trained elementary school nurses using a penlight, 2) hearing screening findings of the otorhinolaryngologist and elementary school nurses, both using the Philippine National Ear Institute (PNEI) Method of 512 Hz Tuning Fork Test (TFT) and 3) PNEI Method of 512 Hz TFT findings and screening audiometry findings.
METHODS:In this continuing study, nurses residing in the venue of the study, and previously trained in ear examination using a penlight and hearing screening using the PNEI 512 Hz TFT, conducted these in school children who attended the hearing screening and medical mission. Otoscopy, PNEI Method of 512 Hz TFT, and screening audiometry were then conducted on the children by the otolaryngologist. The nurses and the otolaryngologist performed independent and blinded assessments.
RESULTS:Eighteen nurses and ninety children participated in the study. Data subjected to Kappa statistics showed good agreement between nurses and otorhinolaryngologist's findings in the examination of the external canal and tympanic membrane and in PNEI Method of 512 Hz TFTs, and between the PNEI Method of 512 Hz TFT and screening audiometry.
CONCLUSION:PNEI methods of penlight ear examination and 512 Hz TFT may be effective tools for early detection of common ear conditions and hearing screening in Filipino school children. These may be conducted in the school setting not only by otorhinolaryngologists but also by adequately trained school nurses.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; Diagnosis ; Nurses ; Hearing ; Audiometry ; Child ; Ear Diseases ; Early Diagnosis ; Humans ; Otolaryngologists ; Otoscopes ; Otoscopy ; Philippines ; Religious Missions ; Schools ; Tympanic Membrane ; Hearing Tests

A line of fibroblast-type cells derived from embryos of a domestic rabbit has been cultivated continuously for over 3 years by serial passages up to the level of the moth passage. The cell line was tentatively named rabbit embryo fibroblast (REF). The establishment of primary culture, serial passages, growth rate and cytology are described in this communication. In addition some of the results of experiments on the detection of Mycoplasma contamination, on storage of the frozen cells and on its susceptibility to vaccinia virus infection are included.
Animal ; Cell Line ; Embryo/cytology* ; Fibroblasts* ; Rabbits ; Tissue Culture*

To grow Mycobacterium leprae in cultured mouse peritoneal macrophages, studies were made on 1) the purification of M. leprae from lepromatous nodules by trypsinization, 2) growth experiment of purified M. leprae in cu1tured macrophages by in vivo infection-in vitro cultivation technique and 3) the observation of pathological changes in sp1eens of mice induced by intraperitoneal inoculation of purified M. leprae. Results are summarized as follows. 1. A simple and effective procedure is described for purification of M. leprae from biopsied nodules of lepromatous leprosy patients by trypsinization and high speed centrifugation. The procedure resulted in a good yie1d of homogeneous preparation of M. leprae with a negligible contamination of tissue debris. 2. Significant decreases were observed in the numbers of acid-fast bacilli in cultured macrophages and of macrophages harboring acid-fast bacilli by the length of intervals between the time of intraperitoneal inoculation of purified M. leprae and the time of initiation of macrophage cultures. 3. Microscopic examination of stained preparations of macrophages cultured by in vivo infection-in vitro cultivation technique indicated that an apparent increase in the number of acid-fast bacilli in the macrophages occurred when the cultures made at 24 hours and 1 week after inoculation were maintained in vitro up to 2 months or more. 4. Pathological changes in the spleens of mice inoculated with purified M. leprae were of mainly degenerative nature in the red pulp. No multiplication of M. leprae was observed in the spleens of mice up to 5 months after inoculation.
Adolescent ; Adult ; Animal ; Cells, Cultured ; Female ; Human ; Leprosy/microbiology* ; Macrophages/microbiology* ; Male ; Mice ; Mycobacterium leprae/growth & development* ; Mycobacterium leprae/isolation & purification ; Peritoneum/microbiology*

Many factors including social rejection, family problems, loss of educational opportunity, fear, prejudice and ignorance of leprosy compound the inherent psychologicaI stress of leprosy. In light of these problems we have undertaken a study to evaluate the psychological status of several selected groups of leprasy patients. We first studied 340 leprosy patients living in resettlement villages and 304 healthy people living in similar isolated areas. We used a self report symptom inventory, SCL-90 (symptom check list-90), and compared the two-groups. (countinued..)
Humans ; Leprosy* ; Prejudice ; Self Report ; Social Distance

Introduction: The contribution of the family environment to childhood obesity in Malaysia is not well known. This paper describes the study, methodology and results of a pilot study to assess the feasibility of conducting a study on diet and lifestyle factors among Malay primary school children and their main caregiver(s) in regard to body weight status. Methods: The Family Diet Study used a cross-sectional design and targeted a minimum of 200 Malay families at five national primary schools in the Klang Valley, Malaysia using a multi-stage sampling method. Participants were Malay families with children aged 8 to 12 years and their main caregiver(s). Data on socio-demographic, dietary intake, parental child feeding practices, physical activity and anthropometric measures were collected predominantly at schools with follow-up 24-h dietary recalls collected by phone. Details of recruitment, inclusion criteria, assessments and statistical analyses are also discussed. Results: Eleven families provided data by answering questionnaires, recalling diet intake and participating in anthropometric measures. The results showed overall feasibility of the study protocol but required some modifications prior to implementation of the main study. Mothers were the main parent involved in family food procurement, preparation and mealtime supervision. Snacking was not commonly reported and fruit and vegetables intakes were generally infrequent. Conclusion: The most novel component of this study was the comprehensive collection of data from both children and their main caregiver(s) within the context of the family. Detailed information on dietary and lifestyle aspects will help to elucidate factors associated with obesity aetiology in Malay children.

According to the World Health Organization, for medical schools to fulfill their obligation of social accountability, it is necessary for medical education, research, and service areas to ref lect the healthcare system’s relevance, quality, cost-effectiveness, and equity. This study utilized Boelen and Heck’s (1995) social accountability grid model to analyze the degree to which the Accreditation Standards of Korean Institute of Medical Education and Evaluation 2019 (ASK2019) standards apply the World Federation for Medical Education’s (WFME) standards. The social accountability characteristics of the former were compared to those of the WFME, the Liaison Committee on Medical Education, and the Australian Medical Council. Experts with experience and certification in medical education and evaluation classified the ASK2019 standards according to the grid model, evaluated social accountability perspectives, and categorized them according to the process, content, and outcome. Of the 92 standards, 61 (66.30%) were selected as social accountability standards; these encompassed all areas. There was a particular focus on outcome-related areas, such as “mission and outcomes,” “student assessment,” “educational evaluation,” and “continuous improvement.” Education and quality were the most common (33, 54.11%), followed by 18 standards related to education and relevance. However, the standards on cost effectiveness and equity corresponding to education, research, and service were significantly insufficient. As a result of classification using a logic model, many criteria were incorporated into the process, producing results similar to those of international accreditation institutions. Therefore, to fulfill medical schools’ social accountability, it is necessary to develop cost effectiveness and equity standards with reference to grid models and expand them beyond education to include research and service areas. Developing content and outcome standards is also required.

Newly developed genetic techniques can reveal mosaicism in individuals diagnosed with monosomy X. Noninvasive prenatal diagnosis using maternal blood can detect most fetuses with X chromosome abnormalities. Low-dose and ultralow-dose estrogen replacement therapy can achieve a more physiological endocrine milieu. However, many complicated and controversial issues with such treatment remain. Therefore, lifetime observation, long-term studies of health problems, and optimal therapeutic plans are needed for women with Turner syndrome. In this review, we discuss several diagnostic trials using recently developed genetic techniques and studies of physiological hormone replacement treatment over the last 5 years.
Diagnosis ; Estrogen Replacement Therapy ; Female ; Fetus ; Genetic Techniques ; Hormone Replacement Therapy ; Humans ; Mosaicism ; Prenatal Diagnosis ; Turner Syndrome* ; X Chromosome

Adult ; Diagnosis, Differential ; Genital Neoplasms, Male ; pathology ; surgery ; Hernia, Inguinal ; pathology ; Humans ; Male ; Myxoma ; pathology ; surgery ; Scrotum ; pathology