Successful middle ear surgery requires the availability of al safe, effective bonding material. Side effect caused by synthetic materials have led to the use of biologic adhesive, However, they carry the risk of transmission of infectious diseases if they are prepared from pooled human blood. The adhesive strength of ammonium sulfate fibrin adhesive produce an adhesive strength that is half that of the homologous commercial product. It is, however, good enough for use in several otolaryngological operations, tympanoplasty, facial nerve repair, reconstruction of ossicles. Reconstruction of posterior wall of ear canal and obliteration of frontal sinus and mastoid antrum using bone dust.
Adhesives ; Ammonium Compounds* ; Ammonium Sulfate* ; Communicable Diseases ; Dust ; Ear Canal ; Ear, Middle ; Facial Nerve ; Fibrin Tissue Adhesive* ; Fibrin* ; Frontal Sinus ; Humans ; Mastoid ; Tympanoplasty

No abstract available.
Fever* ; Microwaves* ; Perfusion*

No abstract available.

Indoleamine 2,3-dioxygenase (IDO) is a key negative regulator of immune responses and has been implicated in tumor tolerance, autoimmune disease and asthma. IDO was detected in the joint synovial tissue in the inflammatory microenvironment of rheumatoid arthritis (RA), but IDO expression in joint synovial tissue is not sufficient to overcome the inflamed synovial environment. This study aimed to unravel the mechanisms involving the failure to activate tolerogenic IDO in the inflamed joint. We demonstrate that both poly (I:C) and lipopolysaccharide (LPS) induce expression of IDO in synovial fibroblasts. However, inflammatory cytokines such as IL-17, TNF-alpha, IL-12, IL-23 and IL-16 did not induce IDO expression. Poly (I:C) appeared to induce higher IDO expression than did LPS. Surprisingly, toll-like receptor (TLR)4-mediated IDO expression was upregulated after depletion of myeloid differentiation primary response protein 88 (MyD88) in synovial fibroblasts using small interfering RNA (siRNA). IDO, TLR3 and TLR4 were highly expressed in synovial tissue of RA patients compared with that of osteoarthritis patients. In addition, RA patients with severe disease activity had higher levels of expression of IDO, TLR3 and TLR4 in the synovium than patients with mild disease activity. These data suggest that upregulation of IDO expression in synovial fibroblasts involves TLR3 and TLR4 activation by microbial constituents. We showed that the mechanisms responsible for IDO regulation primarily involve MyD88 signaling in synovial fibroblasts, as demonstrated by siRNA-mediated knockdown of MyD88.
Adaptor Proteins, Vesicular Transport/genetics/metabolism ; Arthritis, Rheumatoid/*metabolism ; Blotting, Western ; Cells, Cultured ; Fibroblasts/drug effects/*metabolism ; Humans ; Immunohistochemistry ; Indoleamine-Pyrrole 2,3,-Dioxygenase/genetics/*metabolism ; Interleukin-12/pharmacology ; Interleukin-16/pharmacology ; Interleukin-17/pharmacology ; Interleukin-23/pharmacology ; Lipopolysaccharides/pharmacology ; Myeloid Differentiation Factor 88/genetics/*metabolism ; Poly I-C/pharmacology ; Polymerase Chain Reaction ; RNA, Small Interfering/genetics/physiology ; Synovial Membrane/*cytology ; Toll-Like Receptor 4/genetics/metabolism ; Tumor Necrosis Factor-alpha/pharmacology

No abstract available.
Body Weight* ; Cholesterol*

Purpose: This study used a mixed methods research design in an attempt to verify the effects of robot-assisted rehabilitation on the gait ability of stroke patients with hemiplegia, and thereby further understand the benefits and challenges of stroke patients’ experiences relying on robot-assisted rehabilitation. Methods: An exploratory sequential mixed methods study design was used in order to combine both quantitative and qualitative data. For the quantitative data collection, a total of 30 stroke patients with hemiplegia were recruited from one rehabilitation hospital. Qualitative data were collected through individual interviews using semi-structured questionnaires for a group of 15 patients who were currently undergoing robot-assisted rehabilitation. The data were analyzed through qualitative content analysis. Results: As a result of the quantitative analysis, there were significant differences between the two groups in terms of daily living activity patterns, total number of steps, and average walking speed. As a result of the qualitative analysis, the four main themes derived consisted of, ‘curiosity about the usage of robot-assisted rehabilitation,’ ‘pleasure experienced while using the robots,’ ‘insufficient information about robots,’ and ‘a lack of education about robot-assisted rehabilitation.’ Conclusions Robot-assisted rehabilitation had a significant effect on the walking ability of stroke patients with hemiplegia. Additionally, stroke patients with hemiplegia experienced difficulty during the course of their robot-assisted rehabilitation, due to a lack of sufficient information on correct usage techniques. These quantitative and qualitative findings could provide the basic foundation for the development of an educational program on robot-assisted rehabilitation.

BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical

Recently the 2nd generation laboratory composite resins were introduced. Although the mechanical properties of these composite resins have been improved, there were some disadvantages such as discoloration, low abrasion resistance and debonding between metal and resin. The purpose of this study was to evaluate the tensile bond strength between non-pecious dental alloy(verabond) and four veneering reinforced composite resins: Targis(Ivoclar Co.,U.S.A.), Artglass(Kulzer CO., Gemany). Sculpture(Jeneric Pentron Co., U.S.A.), and Estenia(Kurary Co., Japan). All test metal specimens were polished with #1,000 SiC paper, and sandblasted with 250micrometer aluminum oxide. After then, according to manufacturer's instructions metal adhesive primer and veneering resins were applied. All test specimens were divided into two groups. One group was dried in a desiccator at 25degrees C for 3 days, the other group was subjected to thermal cycling(2,000x) in water(5/55degrees C). Tensile bond strength was measured using Instron Universal Testing machine and the fractured surface was examined under the naked eyes and scanning microscope. Within the limitations imposed in this study, the following conclusions can be drawn: 1. in no-thermal cycling groups, there were no significant differences between Estenia and VMK68 but there were significant differences between Targis, Artglass, Sculpture and VMK68(p<0.05). 2. in no-thermal cycling resin groups, the highest tensile bond strength was observed in Estenis and there were significant differences between Estenia and the other resins(p<0.05). 3. Before and after thermal cycling, there were significant differences in tensile bond strength of Targis and Artglass(p<0.05). The tensile bond strength of Artglass was decreased and that of Targis was increased. 4. in no-thermal cycling groups, Artglass showed mixed fracture modes(95%), but after thermal cycling, Artglass showed adhesive fracture modes(75%).
Adhesives ; Aluminum Oxide ; Composite Resins* ; Dental Alloys* ; Sculpture

PURPOSE: The aim of this study was to explore how characteristics of ADHD children affect social support for mothers, parenting stress, parenting sense of competence, coping, and quality of life. The conceptual model was based on the Lazarus and Folkman's stress-evaluation-coping theory. METHODS: Data were collected 208 mothers of children with ADHD. Data were analysed using SPSS 18.0 and AMOS 18.0 programs. RESULTS: The proposed model was good fit for the data based on the model fit indices. Parenting stress, parenting sense of competence and coping directly affected quality of life but characteristics of the children and social support had only an indirect effect. The explanatory power of these variables was 52.1%. CONCLUSION: The results of this study indicate that nursing strategies to increase social support for mothers with ADHD children, lowers parenting stress, improves parenting sense of competence, and guides the parents to choose appropriate coping. In particular, as social support has the strongest influence on the quality of life, it is necessary to develop nursing intervention programs that utilize social support for parents with ADHD children.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Humans ; Mental Competency ; Mothers* ; Nursing ; Parenting ; Parents ; Quality of Life*

A total of 100 Vibrio spp. strains were examined for production of various extracellular enzyme and for plasmid content plasmid were subjected to digestion with restriction enzymes. Most of them produced extracellular enzyme more than one, especially V. parahaemolyticus and V. cholerae non-01 strains were showed production of various extracellular enzymes. About the 55% Vibrio spp. have the plasmid more than one, but a lot of Vibrio spp. (about 45%) did not possess any plasmid. Most of these plasmid various derivatives ranged from 2.4 kb-23 kb, especially two strains of V. mimicus and one strain of V. furnissii carried one high-molecular weight plasmid (molecular weight ranging between 70 kb-100 kb). Results of restriction analysis for plasmid of this three strains were by no means the rule. For detection of tdh and ctx gene, the virulence factor involved in the pathogenesis, we carried out the TDH, CT assay, PCR amplification, and hybridization. A total 11 strains were produced TDH, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 6 strains of environmental isolates. Nine strains of 11 strains, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 4 strains of V. parahaemolyticus from environmental isolates, could be successfully amplified in 400 bp by PCR, no amplification products were obtained from TDH-negative strains. The PCR results were consistent with DNA hybridization. In the experiments of ctx gene detection, in all, 3 strains of V. cholerae non-01 from clinical isolate and 1 strains of V. cholerae non-01 from environmental isolate were observed CT- positive. These CT-producing strains amplified in 302 bp by PCR for the detection of ctx gene. All CT-producing strains hybridized with digoxigenin-labeled DNA probe, while CT-negative strains did not hybridize. Also hybridization tests results for detection of ctx gene consistent with PCR.
Cholera ; Digestion ; DNA ; Plasmids ; Polymerase Chain Reaction ; Vibrio* ; Virulence Factors* ; Virulence*