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.

No abstract available.
Humans ; Internship and Residency*

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

OBJECTIVE: The accuracy of analytical results of blood and urine heavy metals came out to the main issue on occupational health from late eighties. The discrepancy of the results for same samples from different laboratories made the diagnosis for occupational diseases be unreliable. Therefore, a quality control program for analysis of samples taken from workplace had been introduced in Korea since 1992. This study aims to show the quality control program f'or analysis of blood and urine samples and its proficient rates from 1992 to 1999 and to know how they have been being used in occupational health. METHODS: The quality control program runs twice a year with mandatory items of blood lead and urine hippuvic acid and voluntary items of blood cadmium and manganese and urine mandellic acid and methyl hippuric acid. Participant laboratories are receiving three levels for each items and two out of three samples have to be qualified for being a proficient laboratory for the item. The acceptable range of blood lead and urine hippuric acid is +/-15% and that of the others is within 3 SD(standard deviation) from the reference values. RESULTS: The proficient rates of blood lead and urine hippuric acid was 89%, 90%, repectively, however those of the other voluntary items have been from 51% to 62%. The proficient rates of urine mercury and urine N-methylformamide(NMF), which are introduced since 1999, were very poor. Urine hippuric acid and blood lead were analyzed frequently for the purpose of biological monitoring conducting by special health examination organizations. Urine and blood manganese and urine metabolites of trichloroethylene, urine phenol, methylhippuric acid and cadmium were followed. CONCLUSIONS: In conclusion, the quality control program for biological monitoring has dramatically improve the ability of analysing blood and urine samples and eventually contributes to diagnose occupational diseases and to prevent occupational poisoning. However, some biological monitoring data, such as urine manganese, mercury and NMF, have been still reported from laboratories that were not accepted as a proficient laboratory.
Cadmium ; Diagnosis ; Environmental Monitoring ; Korea ; Manganese ; Metals, Heavy ; Occupational Diseases ; Occupational Health ; Phenol ; Poisoning ; Quality Control ; Reference Values ; Trichloroethylene

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