만성 삼출성 중이염 저류액과 아데노이드 조직에서 중합효소연쇄반응(PCR)을 이용하여 검출된 세균의 비교

BACKGROUND AND OBJECTIVES: Otitis media with effusion (OME) is one of the most common reasons for children to seek doctors. Although it is closely related to bacterial infection, the pathogenesis remains unclear. The most common bacteria associated with OME include Haemophilus influenzae (H. influenzae), Streptococcus pneumoniae (S. pneumoniae), and Moraxella catarrhais (M. catarrahalis). These bacteria have consistently been reported to show colony growth on agar. Recently, the analysis using polymerase chain reaction (PCR) has been reported to be much more sensitive for bacteria detection than previous methods, such as culture. In this study, we investigate the possible relationship between bacterial infection in adenoid tissue and middle ear effusion. MATERIALS AND METHODS: Total of 52 middle ear effusion and adenoids were collected from pediatric patients during ventilation tube insertion and adenoidectomy. All the patients had gone through multiple courses of antimicrobial therapies without success. PCR was applied to detect bacteria(H. influenzae, S. pneumoniae, M. catarrha lis) in the middle ear effusion and adenoids. RESULTS: Overall detection rates of bacteria were 57.7% and 46.2% for effusion and adenoids, respectively. Bacterial detection rates of H. influenzae, S. pneumoniae, M. catarrhalis in the middle ear effusion were 30.8%, 19.2%, 11.5%, and in the adenoid were 36.5%, 15.4%, 13.5%, and in both and effusion were 13.5%, 7.7%, 3.8%, respectively. CONCLUSION: PCR is the effective method for detection of bacteria in OME and adenoid tissue. The bacteria found in the adenoid tissue of chronic OME patients did not show any correlation with those found in the OME fluid

신생아 청각선별검사의 결과와 비용효과 분석

BACKGROUND AND OBJECTIVES: It is estimated that more than 2 in every 1,000 neonates suffers from hearing loss. Early detection with appropriate rehabilitation of congenital hearing loss can reduce the adverse developmental consequences such as language delays, and behavior and attention deficits. The purpose of this study is to evaluate our newborn hearing screening program using the combined transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR), and to estimate the cost-effectiveness of our program. MATERIALS AND METHOD: 6,634 infants (5,918 well babies and 716 NICU babies) underwent the newborn hearing screening program at Ajou University Hospital for 4 years. Initially well babies were screened with TEOAEs, and those failing the TEOAEs were tested with the rescreening program. Neonates failing the TEOAE rescreening and the NICU babies were examined with ABR. The cost included personnel, fringe benefits, supplies, equipment and overhead. RESULTS: 660 (11%) out of 5,918 well babies failed the initial TEOAE screening and 27 (0.46%) babies failed the TEOAE rescreening. Eleven babies (0.16%), 3 of the well babies and 8 of the NICU babies, were confirmed to have hearing loss of more than 60 dB. We detected four deaf babies out of these eleven. From the four deaf babies, we confirmed a connexin 26-related deafness and an enlarged vestibular aqueduct syndrome. It cost $6 to screen one infant and$3,700 to detect one infant with hearing loss. CONCLUSION: We could detect 11 babies (0.16%) with hearing loss out of 6,634 neonates during the 4 years. Considering the benefits of early identification and rehabilitation of congenital hearing loss, the cost for the newborn hearing screen program is affordable. The newborn hearing screen should be extended as a national health program

미백보조광 조사가 치아미백의 효과에 미치는 영향

The aim of this study was to evaluate the influence of light energy on the tooth whitening effect of bleaching agent in vitro..Extracted human mandibular molars were sectioned to 2 fragments(mesial. distal) and lingual portions of crown were used in this study. All specimens were stained using a red wine for 24 hours and immersed in artificial saliva. Specimens divided into four groups, group 1 and 2 light-activated by LumaCool (LED, LumaLite, Inc., Spring Valley, USA), group 3 and 4 light-activated by FlipoWhite2 (Plasma acr lamp, Lokki. Australia). Group 1 and 3 bleached with Luma White (LumaLite, Inc., Spring Valley, USA), group 2 and 4 bleached with Polaoffice(SDI, Victoria, Australia). Bleaching treatment performed during 10 minutes every 24 hours and repeated 6 times. During bleaching treatment, distal fragments was light-activated (L) but mesial fragments was not(NL). Shade assessment employed before and after bleaching treatment using spectrophotometer. The results of the change in shade was compared and analysed between NL and L by using paired-sample T test with 95 % level of confidence. There were no significant differences between NL and L with a few exceptions. In group 2, a* value more change in L, in group 3, b* value more change in L, in group 4, a* value less change in L. After bleaching, L* value and △E increased in all groups and the value of a* and b* decreased in all groups. Within the limitation of this test conditions, the results of this study indicate that the light energy has no obvious improving impact on the tooth whitening effect of a bleaching agent.이 연구의 목적은 미백제의 치아미백효과에 미백보조광의 빛에너지의 영향을 평가하는 것이다. 발거된 하악 대구치 치관의 설면을 실험에 사용하였고, 하나의 대구치에서 근심과 원심으로 구분되는 2개의 치아절편을 얻었다. 모든 시편을 24시간동안 적포도주에 보관하여 착색을 유도하고, 인공타액에 보관하였다. 시편들은 미백광조사기와 미백 powder의 종류에 따라 4개의 실험군으로 나뉘었으며, 실험군은 다음과 같다. Group 1 : LumaCool로 광조사를 시행, LumaWhite를 사용 Group 2: LumaCool로 광조사를 시행, Polaoffice를 사용 Group 3: FlipoWhite 2로 광조사를 시행 LumaWhite를 사용 Group 4: FlipoWhite 2로 광조사를 시행, Polaoffce를 사용 미백처치는 10분간 매 24시간마다 총 6회 시행하였고, 미백처치시 동일한 치아에서 얻어진 두 개의 시편 중 원심시편에는 미백광조사를 시행한 반면, 근심시편에는 미백광조사를 시행하지 않았다. 색조의 평가는 spectrophotometer를 사용하여 매 미백처지 전과 후에 시행하였고, 근심측과 원심측에서 얻어진 색조 변화 차이를 paired-sample T test를 이용하여 95%의 신뢰수준으로 비교하였다. 미백처치 후 모든 실험군에서 L* value와 △E의 증가와 a* value와 b* value의 감소가 관찰되었다. Group 2원심 절편의 a* value와 group 3원심절편의 b* value에서의 더 큰 변화와 group 4의 원심절편에서의 a* value가 좀 더 적은 변화를 제외하고, 모든 실험군에서 근심절편과 원심절편사이에서 색조변화의 차이는 통계적 유의성을 보이지 않았다. 이상의 연구 결과에서 미백보조광의 빛에너지는 미백제의 치아미백 효과를 증가시키는 것에 명백한 영향을 주지 않는 것으로 평가되었다

TEOAE를 이용한 신생아 청각선별검사

BACKGROUND AND OBJECTIVES: Hearing impairment is a common congenital disability of the newborn, which has an incidence of 1.5 to 3 per 1,000 infants each year. The identification of this problem is difficult and many of these children are not identified until 2-3 years of age if not screened at birth. The purpose of this study is to establish a common screening method adjusted to our country and to emphasize the importance of early diagnosis of neonatal hearing loss. MATERIALS AND METHODS: TEOAE were performed in 1,459 infants from March to December, 1998 at Ajou university hospital. The tests were performed daily until discharge if the infant had failed the first test, and were followed at the outpatient clinic. Hearing loss was confirmed by ABR. RESULTS: The average test time of TEOAE was 102.6 seconds. Test time after 24 hours of birth was shorter than before 24 hours, and was shorter in female compared to male infants. Pass rate after 24 hours was higher than before 24 hours and 86% of tested infants passed during admission. Thirty-one out of 213 infants failed to follow-up at the outpatient clinic. Two were diagnosed with unilateral hearing loss on ABR. CONCLUSION: TEOAE is a simple and useful screening method for the identification of hearing loss in infants

전신성 홍반성 낭창 환자의 골수 내 면역세포 및 세포 자살에 대한 분석

학위논문 (석사)-- 서울대학교 대학원 : 의학과, 2014. 2. 이은봉.Objectives: To examine the immune cell profile in the bone marrow (BM) of systemic lupus erythematosus (SLE) patients and to assess its clinical relevance. Methods: Sixteen BM samples from 14 SLE patients were compared with seven healthy control samples. The numbers of CD4+ T cells, CD8+ T cells, B cells, plasmacytoid dendritic cells (pDC), macrophages and plasma cells in the BM, and the levels of interleukin-6 (IL-6) expression, were examined by immunohistochemistry. The number of apoptotic cells (active caspase-3+) in the BM was also measured. The association between immune cell subsets and clinical features was also investigated. Results: CD4+ T cells, macrophages and plasma cells were more common in the BM of SLE patients than in healthy controls (1.82±1.45% vs. 0.26±0.12%, p=0.00116.35±7.17% vs. 8.04±1.38%, p=0.004and 9.72±5.64% vs. 3.44±0.64%, p<0.001, respectively). Greater numbers of CD4+ T cells and macrophages were associated with high-grade BM damage. The percentage of apoptotic cells in BM specimens from SLE patients was significantly higher than that in controls (2.47±1.35% vs. 0.19±0.22%, p<0.001) and was positively correlated with the number of pDCs (r=0.606, p=0.013). Increased numbers of plasma cells and high IL-6 expression were correlated with anti-double stranded DNA (dsDNA) antibody levels and the SLE disease activity index (r=0.538, p=0.031 and r=0.581, p=0.013, respectively). Conclusion: BM samples from SLE patients showed a distinct immune cell profile and increased numbers of apoptotic cells. This, coupled with a correlation with disease activity, suggest that the BM may play a critical role in the pathogenesis of SLE.CONTENTS Abstract ………………i Contents …ii List of tables and figures………iii List of abbreviations ……………………………………………………………………iv Introduction 1 Patients and Methods 2 Results 5 Discussion 20 References 24 Abstract in Korean 30Maste

How Large are Local Human Capital Spillovers?: Evidence from Korea

This paper examines the empirical magnitude of local human capital spillovers in Korea during the 1980s and mid-1990s. Local human capital spillovers exists if plants in regions with a higher level of human capital can produce more given their own amount of input (Moretti 2004c). In particular, this paper explores an educational reform in South Korea which exogenously induced a large amount of variation in regional human capital levels. Using annually collected plant level data, I explore the effect of changes in the regional human capital levels induced by this reform on plant productivity in Korea. My results suggest that this effect is limited. I find a positive correlation between a regional level of human capital and plant productivity. However, after further addressing endogeneity using an instrumental variable, the effect of the overall regional human capital level on productivity decreases and becomes statistically insignificant

초기 중이 진주종의 치료

Chronic otitis media with cholosteatoma had been one of the most prevalent forms of otological disease. However, recently, the incidence of chronic otitis media have decreased owing to better economic status and health care. Thus, cases of middle ear surgery have also decreased relatively in number. So it seems that otologists nowadays should be engaged in revision surgery of the middle ear and management of early cholesteatoma. While the incidence of extensive or complicated cholesteatoma has dramatically decreased for last decades, the early staged or less extensive cholesteatoma and retraction pockets are more frequently found. Especially localized adhesive otitis media, usually posterior tympanic membrane, is one of the most difficult dilemmas for the otologist. There are several controversial issues for managing patients with early cholesteatoma：1) conservative care or surgical treatment 2) techniques of surgery 3) whether or not mastoidectomy. So surgery for early cholesteatoma is thought to be reconstructive rather than destructive and it can be a prophylactic operation. I proposed a strategy for the management of early cholesteatoma which was based on safe marsupialization of retraction pocket or cholesteatoma, preservation of the mucosa, adequate ventilation, and prevention of retraction pocket. In case of attic retraction pocket or cholesteatoma, atticotomy with scutumplasty was made. On the other hand, the procedure to remove posterior annular bone and posterior scutum to allow access tympanic sinus and posterior attic space designated as posterior sinusectomy with reconstruction were applied to sinus retraction pocket or cholesteatoma. Early tensa retraction cholesteatoma would be managed as the combination of atticotomy and posterior sinusectomy. So I preferred the term “atticosinoplasty” which includes attic reconstruction with scutumplasty after atticotomy and posterior sinusectomy. If the disease seems to extend to mastoid, endoscopes were introduced transmeatally. If cholesteatoma occupies in mastoid, complete mastoidectomy is made, and sometimes mastoid cavity is obliterated to eliminate the cavity problems. During the last 7 years, I managed surgically 208 cases of attic or sinus cholesteatoma, so-called early cholesteatoma, among which there were 45 cases of atticosinoplasty. I analysed 45 cases with atticosinoplasty with special reference to period of postoperative care and hearing result , as compared to cases with mastoid obliteration and open cavity mastoidectomy. In conclusion, I personally think that middle ear cholesteatoma has a possibility of different clinical entity rather than a kind of chronic otitis media, eustachion tube dysfunction can not be always a prerequisite of middle ear cholesteatoma but it can be a secondary phenomenon, and finally surgury for early cholesteatoma is reconstructive rather than destructive ant it can be a prophylactic operation

Mouse 이관에서 라이소자임과 락토체린 분비세포의 정상분포

BACKGROUND AND OBJECTIVES: Mucosal surfaces in the middle ear and eustachian tube are protected by several complex defense mechanisms, namely mucociliary clearance, immunoglobulins, cellular components, and antibacterial secretory enzymes. The secretory enzymes such as lysozyme and lactoferrin are found in various mucosal tissues and most of body secretions which cover the human mucosal surfaces. Because of their bactericidal activity, it has been suggested that these enzymes contribute to the defense against local mucosal infections. It has been known that lysozyme- and lactoferrin-secreting cells in tubotympanum were various in species such as human, chinchilla, guinea pig and Mongolian gerbil. The purpose of this study is to identify and localize the lysozyme- and lactoferrin-secreting cells in the eustachian tube of normal mice using histochemical and immunohistochemical techniques. MATERIALS AND METHODS: Normal mice (BALB/c, 60-120 days old, 10 heads) were used for staining of tubotympanum with hematoxylin-eosin stain, Alcian blue-periodic acid-Schiff (AB-PAS) stain and immunohistochemical stain (antihuman lysozyme, and antihuman lactoferrin antibodies). RESULTS: 1) Secretory cells in the epithelium and subepithelial glands are observed more in the pharyngeal portion than in the tympanic portion of eustachian tube. Subepithelial glands are also noted more in lower part than in upper part of eustachian tube. 2) Lysozyme was observed in the secreting cells of mucosal epithelium and the serous cells of subepithelial glands. 3) Lactoferrin was observed in the serous cells of subepithelial glands, but not in the epithelium. CONCLUSION: In the eustachian tube of BALB/c mouse, lysozyme and lactoferrin were detected in the serous cells in subepithelial glands and only lysozyme is observed in the secretory cells in the eustachian tube epithelium

Probabilistic Estimation of Incomplete Map Using Gaussian Process

학위논문 (석사)-- 서울대학교 대학원 : 전기공학부, 2013. 8. 오성회.Gaussian process is a powerful probabilistic estimation tool which is used widely in engineering fields such as Computer vision, Robotics and sensor networks, etc. This thesis implemented an estimation algorithm of the total map with sparse sensing data using Gaussian Process. In the implemented algorithm, two kinds of kernel functions are applied to the spatial Gaussian Process modelsquared exponential kernel and neural network kernel. The performance of the proposed algorithm was verified by the experiments with a simple mobile sensor network. To construct a simple mobile sensor network based on ROS (Robot Operating System) platform, a two wheeled mobile robot (Pioneer3DX) and a two dimensional laser scanner (SICKlms200) are used.1 Introduction 1 1.1 Mobile Sensor Network 1.2 Simulataneous Localization and Mapping (SLAM) 1.3 Occupancy Grid Map 2 Related Work 2.1 Mapping 2.2 Sensing and Locating 2.3 Probabilistic Solution for Mapping Problem 3 Gaussian Process (GP) 3.1 Weight-space View 3.1.1 The Standard Linear Model 3.1.2 Projections of Inputs into Feature Space 3.2 Function-space View 3.2.1 Prediction with Noise-free Observations 3.2.2 Prediction using Noisy Observations 3.3 Varying Hyperparameters 4 GP Applied to Mapping Problem 4.1 Overview of Contextual Mapping 4.2 Training Hyperparameters 5 Experimental results 5.1 The Mapping Problem in a Real Indoor Environment 5.2 GP Estimation for Single Frame of Laser Scanner 5.2.1 The given Training Data 5.2.2 Selecting a Kernel Function 5.2.3 Optimizing Hyper-parameters 5.2.4 Estimation 5.3 The Estimation Problem in a Simulated Environment 6 Conclusion 6.1 Contribution of GP for Mapping Problem 6.2 Future WorksMaste