Effects of Early Surgical Exploration in Suspected Barotraumatic Perilymph Fistulas

ObjectivesTreatment of traumatic perilymph fistula (PLF) remains controversial between surgical repair and conservative therapy. The aim of this study is to analyze the outcomes of early surgical exploration in suspected barotraumatic PLF.MethodsNine patients (10 cases) who developed sudden sensorineural hearing loss and dizziness following barotrauma and underwent surgical exploration with the clinical impression of PLF were enrolled. Types of antecedent trauma, operative findings, control of dizziness after surgery, postoperative hearing outcomes, and relations to the time interval between traumatic event and surgery were assessed retrospectively.ResultsAll patients had sudden or progressive hearing loss and dizziness following trauma. Types of barotrauma were classified by the origin of the trauma: 4 external (car accident, slap injury) and 6 internal traumas (lifting, nasal blowing, straining). Surgical exploration was performed whenever PLF was suspected with the time interval of 2 to 47 days after the trauma. The possible evidence of PLF was found during surgery in 9 cases: a fibrous web around the oval window (n=3), fluid collection in the round window (RW; n=6) and bulging of the RW pseudomembrane (n=1). In every patient, vestibular symptoms disappeared immediately after surgery. The hearing was improved with a mean gain of 27.0±14.9 dB. When the surgical exploration was performed as early as less than 10 days after the trauma, serviceable hearing (≤40 dB) was obtained in 4 out of 7 cases (57.1%).ConclusionSudden or progressive sensorineural hearing loss accompanied by dizziness following barotrauma should prompt consideration of PLF. Early surgical exploration is recommended to improve hearing and vestibular symptoms

Pharmacokinetic study of meropenem in healthy beagle dogs receiving intermittent hemodialysis

Meropenem, a second carbapenem antimicrobial agent with a broad spectrum of activity, is used to treat sepsis and resistant-bacterial infections in veterinary medicine. The objective of this study was to identify the pharmacokinetics of meropenem in dogs receiving intermittent hemodialysis (IHD) and to determine the proper dosing in renal failure patients receiving IHD. Five healthy beagle dogs were given a single i.v. dose of 24 mg/kg of meropenem and received IHD. The blood flow rate, dialysate flow, and ultrafiltration rate were maintained at 40 mL/min, 300 mL/min, and 40 mL/h, respectively. Blood samples were collected for 24 h from the jugular vein and from the extracorporeal arterial and venous line. Urine samples and dialysate were also collected. The concentrations of meropenem were assayed using HPLC/MS/MS determination. The peak plasma concentration was 116 +/- 37 mu g/mL at 15 min. The systemic clearance was 347 +/- 117 mL/h/kg, and the steady-state volume of distribution was 223 +/- 67 mL/kg. Dialysis clearance was 71.1 +/- 34.3 mL/h/kg, and the extraction ratio by hemodialysis was 0.455 +/- 0.150. The half-life (T-1/2) in dogs with IHD decreased compared with those without IHD, and the reduction in T1/2 was greater in renal failure patients than in normal patients. Sixty-nine percent and 21% of the administered drug were recovered by urine and dialysate in the unchanged form, respectively. In conclusion, additional dosing of 24 mg/kg of meropenem after dialysis could be necessary according to the residual renal function of the patient based on the simulated data.OAIID:RECH_ACHV_DSTSH_NO:T201621129RECH_ACHV_FG:RR00200001ADJUST_YN:EMP_ID:A003050CITE_RATE:1.279FILENAME:Byun_et_al-2016-Journal_of_Veterinary_Pharmacology_and_Therapeutics.pdfDEPT_NM:수의학과EMAIL:[email protected]_YN:YFILEURL:https://srnd.snu.ac.kr/eXrepEIR/fws/file/eb2b2d93-6cb2-4420-a374-90eb43215957/linkCONFIRM:

Characteristics of greenhouse gas concentrations derived from ground-based FTS spectra at Anmyeondo, South Korea

Since the late 1990s, the meteorological observatory established in Anmyeondo (36.5382° N, 126.3311° E, and 30 m above mean sea level) has been monitoring several greenhouse gases such as CO_2, CH_4, N_2O, CFCs, and SF_6 as a part of the Global Atmosphere Watch (GAW) Program. A high resolution ground-based (g-b) Fourier transform spectrometer (FTS) was installed at this observation site in 2013 and has been operated within the frame work of the Total Carbon Column Observing Network (TCCON) since August 2014. The solar spectra recorded by the g-b FTS cover the spectral range 3800 to 16 000 cm^(−1) at a resolution of 0.02 cm^(−1). In this work, the GGG2014 version of the TCCON standard retrieval algorithm was used to retrieve total column average CO_2 and CH_4 dry mole fractions (XCO_2, XCH_4) and from the FTS spectra. Spectral bands of CO_2 (at 6220.0 and 6339.5 cm^(−1) center wavenumbers, CH_4 at 6002 cm^(−1) wavenumber, and O_2 near 7880 cm^(−1)) were used to derive the XCO_2 and XCH_4. In this paper, we provide comparisons of XCO_2 and XCH_4 between the aircraft observations and g-b FTS over Anmyeondo station. A comparison of 13 coincident observations of XCO_2 between g-b FTS and OCO-2 (Orbiting Carbon Observatory) satellite measurements are also presented for the measurement period between February 2014 and November 2017. OCO-2 observations are highly correlated with the g-b FTS measurements (r^2 = 0.884) and exhibited a small positive bias (0.189 ppm). Both data set capture seasonal variations of the target species with maximum and minimum values in spring and late summer, respectively. In the future, it is planned to further utilize the FTS measurements for the evaluation of satellite observations such as Greenhouse Gases Observing Satellite (GOSAT, GOSAT-2). This is the first report of the g-b FTS observations of XCO_2 species over the Anmyeondo station

Genetic Alterations in Intrahepatic Cholangiocarcinoma as revealed by Degenerate Oligonucleotide Primed PCR-Comparative Genomic Hybridization

Intrahepatic cholangiocarcinoma (ICC), a malignant neoplasm of the biliary epithelium, is usually fatal because of difficulty in early diagnosis and lack of availability of effective therapy. The genetic mechanisms involved in the development of ICC are not well understood and only a few cytogenetic studies of ICC have been published. Recently, technique of degenerate oligonucleotide primed (DOP)-PCR comparative genomic hybridization (CGH) permits genetic imbalances screening of the entire genome using only small amounts of tumor DNA. In this study chromosomal aberrations in 33 Korean ICC were investigated by DOP-PCR CGH. The common sites of copy number increases were 20q (67%), 17 (61%), 11q11-q13 (42%), 8p12-qter (39%), 18p (39%), 15q22-qter (36%), 16p (36%), 6p21 (30%), 3q25-qter (27%), 1q41-qter (24%), and 5p14-q11.2 (24%). DNA amplification was identified in 16 carcinomas (48%). The frequent sites of amplification were 20q, 17p, 17q23-qter, and 7p. The most frequent sites of copy number decreases were 1p32-pter (21%) and 4q (21%). The recurrent chromosomal aberrations identified in this study provide candidate regions involved in the tumorigenesis and progression of ICC

Analysis of Fuel Cell Driven Ground Source Heat Pump Systems in Community Buildings

In the present study, a fuel cell driven ground source heat pump (GSHP) system is applied in a community building and heat pump system performance is analyzed by computational methods. Conduction heat transfer between the brine pipe and ground is analyzed by TEACH code in order to predict the performance of the heat pump system. The predicted coefficient of performance (COP) of the heat pump system and the energy cost were compared with the variation of the location of the objective building, the water saturation rate of the soil, and the driven powers of the heat pump system. Compared to the late-night electricity driven system, a significant reduction of energy cost can be accomplished by employing the fuel cell driven heat pump system. This is due to the low cost of electricity production of the fuel cell system and to the application of the recovered waste heat generated during the electricity production process to the heating of the community building

Comparison of Regional Simulation of Biospheric CO2 Flux from the Updated Version of CarbonTracker Asia with FLUXCOM and Other Inversions over Asia

There are still large uncertainties in the estimates of net ecosystem exchange of CO2 (NEE) with atmosphere in Asia, particularly in the boreal and eastern part of temperate Asia. To understand these uncertainties, we assessed the CarbonTracker Asia (CTA2017) estimates of the spatial and temporal distributions of NEE through a comparison with FLUXCOM and the global inversion models from the Copernicus Atmospheric Monitoring Service (CAMS), Monitoring Atmospheric Composition and Climate (MACC), and Jena CarboScope in Asia, as well as examining the impact of the nesting approach on the optimized NEE flux during the 2001–2013 period. The long-term mean carbon uptake is reduced in Asia, which is −0.32 ± 0.22 PgC yr−1, whereas −0.58 ± 0.26 PgC yr−1 is shown from CT2017 (CarbonTracker global). The domain aggregated mean carbon uptake from CTA2017 is found to be lower by 23.8%, 44.8%, and 60.5% than CAMS, MACC, and Jena CarboScope, respectively. For example, both CTA2017 and CT2017 models captured the interannual variability (IAV) of the NEE flux with a different magnitude and this leads to divergent annual aggregated results. Differences in the estimated interannual variability of NEE in response to El Niño–Southern Oscillation (ENSO) may result from differences in the transport model resolutions. These inverse models’ results have a substantial difference compared to FLUXCOM, which was found to be −5.54 PgC yr−1. On the one hand, we showed that the large NEE discrepancies between both inversion models and FLUXCOM stem mostly from the tropical forests. On the other hand, CTA2017 exhibits a slightly better correlation with FLUXCOM over grass/shrub, fields/woods/savanna, and mixed forest than CT2017. The land cover inconsistency between CTA2017 and FLUXCOM is therefore one driver of the discrepancy in the NEE estimates. The diurnal averaged NEE flux between CTA2017 and FLUXCOM exhibits better agreement during the carbon uptake period than the carbon release period. Both CTA2017 and CT2017 revealed that the overall spatial patterns of the carbon sink and source are similar, but the magnitude varied with seasons and ecosystem types, which is mainly attributed to differences in the transport model resolutions. Our findings indicate that substantial inconsistencies in the inversions and FLUXCOM mainly emerge during the carbon uptake period and over tropical forests. The main problems are underrepresentation of FLUXCOM NEE estimates by limited eddy covariance flux measurements, the role of CO2 emissions from land use change not accounted for by FLUXCOM, sparseness of surface observations of CO2 concentrations used by the assimilation systems, and land cover inconsistency. This suggested that further scrutiny on the FLUXCOM and inverse estimates is most likely required. Such efforts will reduce inconsistencies across various NEE estimates over Asia, thus mitigating ecosystem-driven errors that propagate the global carbon budget. Moreover, this work also recommends further investigation on how the changes/updates made in CarbonTracker affect the interannual variability of the aggregate and spatial pattern of NEE flux in response to the ENSO effect over the region of interest

Application of Bias- and Variance-Corrected SST on Wintertime Precipitation Simulation of Regional Climate Model over East Asian Region

In this study, the regional climate of East Asia was dynamically downscaled using Hadley Centre Global Environmental Model version 3-Regional Atmosphere (HadGEM3-RA) forced by the historical simulation data (1979-2005) of HadGEM2-AO produced by the National Institute of Meteorological Sciences (NIMS). To understand the impact of corrected SST on regional climate simulation, we integrated the experiments using uncorrected (UC_SST) and Bias- and Variance-corrected (BCVC_SST) HadGEM2-AO SST and used the simulated data driven by the ERA-Interim reanalysis data and HadGEM2-AO data. Examination of the spatial distribution, statistics, and interannual variation on wintertime precipitation over East Asia indicates that BCVC_SST reduced the overestimation of the climatological mean precipitation. In order to understand the impact of corrected SST on variability, we investigated the relationship between winter snowfall in South Korea and SST over East Asia. The negative correlation coefficient between the winter precipitation and the SST of the seas surrounding Korea appears in the result of observation data. The experiment result using BCVC_SST simulated the negative correlation between the winter snowfall and the SST around Korea more realistically than that of the simulations using UC_SST and HadGEM2-AO data. These results indicate that corrected SST helps to improve the variability of snowfall and SST simulated by HadGEM3-RA. However, time lag about the years when had peak point of SST appeared in the results compared between BCVC_SST experiment and observation data. The peak years shown in the result of the BCVC_SST experiment were similar to that of HadGEM2-AO data. At these results, even though the corrected SST improves climatological mean and variability of simulated data, it has the limitation not to overcome the error such as time lag showed in GCM SST. Additionally, the analysis of the snowfall in South Korea describes that SST is passively used for the source of snowfall and atmospheric variables mainly lead the intensity and the amount of snowfall

Anesthetic management for inhibiting sympathetic activation in an adolescent patient diagnosed with catecholaminergic polymorphic ventricular tachycardia and undergoing left cardiac sympathetic denervation: A case report

Key Clinical Message Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a genetic disorder in which catecholamine release during exercise or emotional stress cause fatal tachyarrhythmias. In this paper, we discuss methods to minimize the sympathetic stimulation that can occur during the perioperative period in patients undergoing left cardiac sympathetic denervation to surgically treat CPVT

Investigation of Added Value in Regional Climate Models for East Asian Storm Track Analysis

Studies have shown that regional climate models (RCMs) can simulate local climates at a higher resolution for specific regions compared to global climate models (GCMs), making dynamic downscaling using RCMs a more effective approach. Therefore, RCMs have become valuable tools for evaluating the potential impacts of climate change on specific regions and for informing local adaptation strategies. To fully understand the added value (AV) of RCMs, it is essential to understand how the characteristics differ between land and ocean. The complex topography of East Asia, including land and sea, makes it a suitable region for evaluating the AV of RCMs. In this study, we compared two regional simulations that integrated the same RCMs but employed different GCMs from the Coordinated Regional Climate Downscaling Experiment for their ability to simulate storm tracks in East Asia. The results of the RCMs for the period from 1982 to 2005 were compared with their host Coupled Model Intercomparison Project GCM projections and high-resolution reanalysis. In mountainous regions, the AV of the RCMs weakened the bias of the GCM and improved its agreement with the reanalysis due to the dynamical process near the high-resolution topography. In plains and coastal areas, owing to the increase in horizontal resolution and clearly determined coastline in RCMs, small-scale phenomena are well represented, and the storm track of RCMs shows similar values to that of the GCM in maritime regions. This study demonstrates the value of RCMs for improving the accuracy of climate projections in East Asia, informing adaptation strategies, and enhancing climate research