Improving Accuracy and Reliability of Hearing Tests: An Exploration of International Standards

This study explores the internal standards for hearing tests and benefits of implementing international standard protocols, including the International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC), and discusses how ISO and IEC standards provide a framework for designing, calibrating, assessing hearing test instruments and methods, and exchanging and comparing data globally. ISO and IEC standards for hearing tests improve accuracy, reliability, and consistency of test results by applying standardized methods and environments. Moreover, they promote international harmonization and data interoperability, enabling information exchange and research collaboration. Those standards for hearing tests are beneficial but have challenges and limitations, such as variation in equipment and calibration, lag in updating standards, variation in implementation and compliance, and lack of coverage of clinical aspects, cultural diversity, and linguistic diversity. These affect the quality and interpretation of test results. Adapting ISO or IEC standards locally would improve their applicability and acceptability, while balancing customization and compatibility with global standards.

Licochalcone H Induces Cell Cycle Arrest and Apoptosis in Human Skin Cancer Cells by Modulating JAK2/STAT3 Signaling

Licochalcone H (LCH) is a phenolic compound synthetically derived from licochalcone C (LCC) that exerts anticancer activity. In this study, we investigated the anticancer activity of LCH in human skin cancer A375 and A431 cells. The 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) cell viability assay was used to evaluate the antiproliferative activity of LCH. Cell cycle distribution and the induction of apoptosis were analyzed by flow cytometry. Western blotting assays were performed to detect the levels of proteins involved in cell cycle progression, apoptosis, and the JAK2/STAT3 signaling pathway. LCH inhibited the growth of cells in dose- and time-dependent manners. The annexin V/propidium iodide double staining assay revealed that LCH induced apoptosis, and the LCH-induced apoptosis was accompanied by cell cycle arrest in the G1 phase. Western blot analysis showed that the phosphorylation of JAK2 and STAT3 was decreased by treatment with LCH. The inhibition of the JAK2/STAT3 signaling pathway by pharmacological inhibitors against JAK2/STAT3 (cryptotanshinone (CTS) and S3I-201) simulated the antiproliferative effect of LCH suggesting that LCH induced apoptosis by modulating JAK2/STAT3 signaling.

Bioactive Sphingolipids as Major Regulators of Coronary Artery Disease

Atherosclerosis is the deposition of plaque in the main arteries. It is an inflammatory condition involving the accumulation of macrophages and various lipids (low-density lipoprotein [LDL] cholesterol, ceramide, S1P). Moreover, endothelial cells, macrophages, leukocytes, and smooth muscle cells are the major players in the atherogenic process. Sphingolipids are now emerging as important regulators in various pathophysiological processes, including the atherogenic process. Various sphingolipids exist, such as the ceramides, ceramide-1-phosphate, sphingosine, sphinganine, sphingosine-1-phosphate (S1P), sphingomyelin, and hundreds of glycosphingolipids. Among these, ceramides, glycosphingolipids, and S1P play important roles in the atherogenic processes. The atherosclerotic plaque consists of higher amounts of ceramide, glycosphingolipids, and sphingomyelin. The inhibition of the de novo ceramide biosynthesis reduces the development of atherosclerosis. S1P regulates atherogenesis via binding to the S1P receptor (S1PR). Among the five S1PRs (S1PR1-5), S1PR1 and S1PR3 mainly exert anti-atherosclerotic properties. This review mainly focuses on the effects of ceramide and S1P via the S1PR in the development of atherosclerosis. Moreover, it discusses the recent findings and potential therapeutic implications in atherosclerosis.

Bioactive Sphingolipids as Major Regulators of Coronary Artery Disease

Atherosclerosis is the deposition of plaque in the main arteries. It is an inflammatory condition involving the accumulation of macrophages and various lipids (low-density lipoprotein [LDL] cholesterol, ceramide, S1P). Moreover, endothelial cells, macrophages, leukocytes, and smooth muscle cells are the major players in the atherogenic process. Sphingolipids are now emerging as important regulators in various pathophysiological processes, including the atherogenic process. Various sphingolipids exist, such as the ceramides, ceramide-1-phosphate, sphingosine, sphinganine, sphingosine-1-phosphate (S1P), sphingomyelin, and hundreds of glycosphingolipids. Among these, ceramides, glycosphingolipids, and S1P play important roles in the atherogenic processes. The atherosclerotic plaque consists of higher amounts of ceramide, glycosphingolipids, and sphingomyelin. The inhibition of the de novo ceramide biosynthesis reduces the development of atherosclerosis. S1P regulates atherogenesis via binding to the S1P receptor (S1PR). Among the five S1PRs (S1PR1-5), S1PR1 and S1PR3 mainly exert anti-atherosclerotic properties. This review mainly focuses on the effects of ceramide and S1P via the S1PR in the development of atherosclerosis. Moreover, it discusses the recent findings and potential therapeutic implications in atherosclerosis.

Translation and Standardization for a Korean Version of the Client Oriented Scale of Improvement / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Client Oriented Scale of Improvement (COSI) has been designed to identify client needs, changes in listening ability, and final listening ability in situations important to each client. The aim of this study was to translate COSI into Korean with subsequent linguistic validation and to determine the reliability of the Korean version of the COSI (K-COSI). SUBJECTS AND METHOD: An expert panel translated the original version of COSI into the Korean language. A bilingual translator back-translated the translated version into English, which was subsequently compared with the original English version. K-COSI was administered at 14 referral hospitals, to 128 patients with hearing disability after cognitive debriefing. Reliability was assessed using correlation study. RESULTS: K-COSI showed an excellent test-retest correlation and high reliability in degree of change (Spearman correlation=0.89, interclass correlation coefficient=0.922). It also showed a fair test-retest correlation and high reliability in final hearing ability (Spearman correlation=0.49, interclass correlation coefficient=0.353) CONCLUSION: K-COSI proved to be highly reliable. The results suggest that the adapted Korean version of COSI is a reliable and valid measure for Korean-speaking patients with hearing loss.

Standardization for a Korean Version of the Speech, Spatial and Qualities of Hearing Scale: Study of Validity and Reliability / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Speech, Spatial and Qualities of Hearing Scale (SSQ) was designed to measure self-reported auditory disability in a wide variety of listening situations. Its 49 items cover many aspects of speech perception, spatial hearing, and qualities of hearing, which constitute the three parts of SSQ. However, there has been no reliable and valid Korean version of SSQ (K-SSQ), which made the measurement of auditory disability difficult. The aim of this study is to develop a K-SSQ and to determine its reliability and validity for clinical or academic use. SUBJECTS AND METHOD: An expert panel translated the original SSQ into Korean. A bilingual translator back-translated the translated version into English, which was then compared with the original version. After cognitive debriefing, K-SSQ was administered to 400 patients with hearing disability in 14 referral hospitals. Reliability was assessed using Cronbach's alpha coefficient and correlation study. Validity was evaluated by factor analysis and criterion validity based on the results of pure tone audiometry. RESULTS: K-SSQ showed good reliability with high internal consistency (Cronbach's α=0.99), and strong positive correlations across all three parts of SSQ. Construct validity was confirmed by the results of factor analysis and criterion validity demonstrated positive correlations between each part of SSQ and the results of pure tone audiometry. CONCLUSION: The K-SSQ is a reliable and valid tool for use as a behavioral measure of hearing ability in Korean-speaking patients, and it will provide a very useful evaluation tool for both clinicians and researchers.

Correlation between Coarse Airborne Particulate Matter and Mortality Rates of Malignant Neoplasm

BACKGROUND: There have been growing interests in harmful effects of dust particles on human health. It has been reported that dust particles negatively affected respiratory and cardiovascular systems. Relationship of dust particles and lung cancer incidence was also investigated. However, there is a lack of studies regarding the relationship between dust particles and cancers except for lung cancer. Therefore, this study aimed to determine the relationship of dust particle concentration and cancer mortality in Korea. METHODS: Average concentration of coarse dust particles (particulate matter 10, PM₁₀) of 2008-2014 were obtained from AirKorea website and cancer mortality was found in Statistics Korea for 2008-2014. Correlation analyses using PM₁₀ and cancer mortality were performed. Age-adjusted death rate (AADR) was used for correlation analysis because a number of death and mortality rate do not reflect population and age of death. Regional annual PM₁₀ was matched with AADR of identical area. Correlation between two variables was presented in scatter plots and Pearson's correlation analysis was performed. RESULTS: PM₁₀ concentration was positively correlated with AADR of malignant neoplasm, lung cancer, stomach cancer, colon cancer, uterus cancer, and leukemia. PM₁₀ concentration was significantly correlated with AADR of malignant neoplasm (r=0.247, P=0.009), lung cancer (r=0.277, P=0.003), stomach cancer (r=0.434, P=0.000), colon cancer (r=0.377, P=0.000), and uterus cancer (r=0.226, P=0.017). CONCLUSION: This study suggested that cancer patients or high-risk group for cancer should pay attention to PM₁₀ concentration. Large-scale studies should investigate the relationship of PM10 concentration and cancer incidence including cancer mortality to extend understanding of this cross-section study.

Morphometric Analysis of the Skull by Moire Contourography / 체질인류학회지

The non-metric analysis of the skulls is very useful for estimating sex and determination of ancestry, the accuracy tends to depend on the amount of experiences of the observers, and so inter-observer errors might be happened. Many researchers are trying to find out more objective methods for determination of ancestry. The purpose of this presentation is to show the usefulness of moire contourography for analyzing the skull. The master screen that is similar to the gratings was made by steel rods, which were arranged as equally spaced parallel lines. Halogen light source was illuminated by lantern slide projector. The skeletal materials were documented crania, composed of 87 male and 47 female, from William M. Bass Donated Skeletal Collection housed at the Department of Anthropology, University of Tennessee. The skulls were placed just behind the master screen as anatomical position using cubic craniophore. The angle between the light source and camera was 65degrees, the distance between camera and the master screen was 1.2 m. Frontal view, left lateral and right lateral view were taken. From the frontal view, fringe patterns were analyzed for first five contour lines which were mainly located around the Glabella. The results were as followed; Type I for male was 53% and female was 4%; Type II for male was 29% and female was 2%; Type III for male was 2% and female was 15%; Type IV for male was 6% and female was 55%. From the lateral view, fringe patterns were analyzed for first four contour lines. However, first and second contour lines were critical to determine the shape and the results were as followed; Type I for male was 52% and female was 22%; Type II for male was 38% and female was 26%; Type III for male was 8% and female was 17%; Type IV for male was 2% and female was 35%. According to this study, different fringe patterns might be dependent on the degree of development of bone marker such as Glabella, Supercillary arch, Euryon and Mastoid process. For example, Supercillary arches were very well developed and slope of forehead above the Glabella was declined, fringe pattern showed reverse triangle shape. If Supercillary arches were poorly developed and slope of forehead above the Glabella was flat, fringe pattern showed home plate shape. The present research shows that moire contourography might be used as more objective methods for estimating sex. And it would be helpful to determine the ancestry when the lateral aspects were analyzed. In the future, continuing study need to be performed with same master screen for different ancestry.

Validation Study of Discriminating Sex using the Atlas from the Digital Korean 3D Human Body Modeling / 체질인류학회지

Estimation of biological profile for skeletal remains by forensic anthropological examination would be possible based on physical anthropological studies which were statistically analyzed. However, physical anthropological studies for Korean population are not enough to establish biological profile for Korean because there is lack of documented osteological specimens in Korea. Recent study suggested that physical anthropological examination could be possible on the three dimensional data which were reconstructed from computed tomography, instead of preparing skeletal specimen by defleshing bone. One of the aim of this study is to evaluate Digital Korean database which were composed of computed tomographic images of 100 cadavers. The other is to perform statistical analysis on morphometrics for segmented atlas whether the results could be helpful to estimate sex in Korean. We measured 100 segmentation atlases (male 51, female 49) from the Digital Korean database which were under the control of Catholic Institute for Applied Anatomy, The Catholic University of Korea. Measurements of segmented atlas were carried out by using Mimics software (Simulation module, Version 13.0, Materialise NV, Belgium), and values of measurement were performed statistical analysis by IBM(R) SPSS(R) (version 20.0, Armonk, New York). Among 19 measurements, the width of atlas showed most crucial element for estimating sex, which was consistent with the result using dried bones of atlas and hit ratio of discriminant functions was 88.0%. 76.7 was the cut-off score of discriminant functions. This results showed that morphometrics for segmented atlas could be helpful in estimating sex using the Digital Korean database. In the future, we expect that the other researchers could more actively use the Digital Korean database as a good specimen for physical and forensic anthropological study.

Feasibility of FRAX for Prediction of Osteoporotic Vertebral Fractures in Korea

STUDY DESIGN: Retrospective study. PURPOSE: To assess the feasibility and limitations of fracture risk assessment tool (FRAX) for osteoporotic vertebral fractures in the Korean population. OVERVIEW OF LITERATURE: The FRAX algorithm is country specific and uses clinical risk factor data to calculate an individual patient's 10-year probability of hip fracture and 10-year probability of major osteoporotic fracture. However, it has not been adequately investigated for Korean. METHODS: One hundred ninety four patients who had all risk factor data for the calculation of FRAX were divided into two groups depending on the existence of vertebral fractures: the fracture group was comprised of 88 patients and the non-facture group comprised of 105 patients. We analyzed prediction of the fracture by applying respectively the Korean, Japanese, USA and UK model, and compared their FRAX results by calculating lumbar bone mineral density (BMD) instead of femoral neck BMD. RESULTS: The prediction of vertebral fracture using FRAX was 10.9 +/- 6.2% in the fracture group, 9.5 +/- 5.5% of the non-fracture group in the Korean model (p = 0.108); 17.9 +/- 10.2% in the fracture group, 14.6 +/- 9.0% in the non-fracture group in the Japanese model (p = 0.017). Only the Japanese model exhibited significant difference in vertebral fracture risk. The prediction of vertebral fracture using lumbar BMD instead of femoral neck BMD was 19.5 +/- 12.1% in the fracture group, 16.0 +/- 10.3% in the non-fracture group in the Korean model (p = 0.029). All models had statistically significant differences for the prediction of osteoporotic vertebral fracture. CONCLUSIONS: The 10-year probability of osteoporotic vertebral fracture had underestimation of the risk considering treatment eligibility based on the National Osteoporosis Foundation guidelines. BMD that accurately reflects the contribution of each result to fracture risk should be preferred for the prediction of fracture using FRAX, when lumbar spine and hip BMD measurements are both performed for clinical purposes in Korean.

A Case of Malignant Small Round Cell Tumor of Temporal Bone with Facial Paralysis

Malignant small round cell tumor is very rare, especially in the head and neck area. It is also difficult to make a differential diagnosis due to their undifferentiated or primitive character. Immunohistochemical staining and chromosomal study is useful to categorize these tumors. Since these are rare tumors, treatment protocols are is not well established. While combined treatments (surgery, chemotherapy, radiotherapy) is currently being applied, the tumor still has a poor prognosis. We present a rare case of a rapidly growing temporal bone malignant small round cell tumor which initially showed facial paralysis.

A Case of Malignant Small Round Cell Tumor of Temporal Bone with Facial Paralysis

Malignant small round cell tumor is very rare, especially in the head and neck area. It is also difficult to make a differential diagnosis due to their undifferentiated or primitive character. Immunohistochemical staining and chromosomal study is useful to categorize these tumors. Since these are rare tumors, treatment protocols are is not well established. While combined treatments (surgery, chemotherapy, radiotherapy) is currently being applied, the tumor still has a poor prognosis. We present a rare case of a rapidly growing temporal bone malignant small round cell tumor which initially showed facial paralysis.

Treatment Strategy for Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

Sudden sensorineural hearing loss is an emergent disease in otologic field. Because the etiology and pathological mechanism were not proven yet, treatment protocol was not established. Therefore, medications, duration, and dosage were different from each institute. In this review, authors collected and analyzed articles on sudden sensorineural hearing loss published during recent 11 years. From those, we described the recommendations on the criteria and method of diagnosis, tools for treatment and their results, and guideline for reporting results and follow up.

Treatment Response of Modified Tinnitus Retraining Therapy with Medical Therapy in the Patients with Tinnitus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: According to the neurophysiologic model of tinnitus, emotion and autonomic nervous systems are closely related to generation of tinnitus. We performed this study to evaluate the treatment response of modified tinnitus retraining therapy (TRT) with medication in the patients with sensorineural tinnitus. SUBJECTS AND METHOD: Forty-three tinnitus patients who were diagnosed as sensorineural tinnitus through audiologic evaluation and have normal hearing in speech frequency were included in this study. Tinnitus and psychological status were measured by tinnitus questionnaire, Korean version of Brief Encounter Psychosocial Instrument (BEPSI) scale, Beck Depression Inventory (BDI), Spielberger State Trait Anxiety Inventory (STAI). Patients treated with anxiolytics and microcirculation enhancer were Group 1 and those treated with modified TRT and medications were Group 2. Short-term therapeutic response was analyzed and compared between two groups. RESULTS: Loudness, awareness, annoyance and effect on life of tinnitus and tinnitus handicap score were significantly decreased in Group 2. Relief of tinnitus in more than 2 of 4 subjective parameters was achieved in 4 patients (30.7%) in Group 1 and 15 patients (75%) in Group 2. Stress score was also decreased significantly after treatment in Group 2. CONCLUSION: Tinnitus patients in Group 2 treated with medication and modified TRT showed the higher compliance and the response rate of treatment than the patients in Group 1 treated with medication alone. Modified TRT, in addition to medical therapy, should be considered to increase the therapeutic response in patients with sensorineural tinnitus.

Determination of Sex in Koreans using Atlas / 체질인류학회지

When forensic anthropologists tried to reconstruct the biological profile, they would rely on the statistical data of documented human osteological/anatomical specimens. However, the metric data of Korean ancestry which is suitable for determining sex has not been established because documented human skeletal specimens are lack in Korean. The aim of this study is to discuss the possibility of determination of sex by metric data of atlas in Koreans. We measured 43 (male 25 and female 18) atlas from the department of anatomy, College of Medicine, Soonchunhyang University and the department of anatomy, Yonsei University College of Medicine. We measured 21 measurements of atlas using digimatic caliper and performed statistic analysis using SPSS to establish the discriminant functions. Among 21 measurements of atlas, the measurement values of the width of atlas exhibited the strongest relation with sexes. The accuracy of arbitrary discriminant functions derived from 6 measurements exhibited 93.9% and that of stepwise discriminant functions derived from 3 measurements exhibited 97.0%. In conclusion, this study could indicate that metric data of atlas is helpful to determine the sex in Koreans, but a further investigation should be followed.

The Effectiveness of Bone Mineral Density as Supplementary Tool for Evaluation of the Osteogenic Potential in Patients with Spinal Fusion

STUDY DESIGN: Retrospective study. PURPOSE: This study was designed to determine the effectiveness of bone mineral density measurement as a supplementary tool for evaluation of osteogenic potential in patients with spinal fusion. To this end, we correlated bone mineral density (BMD) with osteogenic potential from cultured mesenchymal stem cells (MSCs). OVERVIEW OF LITERATURE: Many studies have correlated osteogenic potential of in vitro cultured MSCs with aging or osteoporosis. METHODS: We studied twenty-five individuals with harvested bone marrow from the ilium during lumbar spinal surgery. The BMD of the femoral neck was measured using dual energy X-ray absorptiometry prior to bone marrow aspiration, and the osteoporotic group was classified as those with T-scores below-2.5. After MSCs were isolated from bone marrow, in vitro induction of osteogenesis was performed. We analyzed the patient's osteogenic potential from cultured MSCs such as mineral deposition stain, bone alkaline phosphatase (ALP) activity and osteoblast-specific gene expression in RT-PCR. RESULTS: On mineral staining, the osteoporotic group had a scanty matrix mineral deposition in contrast to the non-osteoporotic group. The expression of osteocalcin in the osteoporotic group was 1.5 to 3 times less than in the non-osteoporotic group. At the 3rd week after the induction of osteogenesis, the activity of ALP of cultured MSCs in the osteoporotic group was lower than in the control group (mean, 45+/-19 u/L, in osteoporotic group vs 136+/-7 u/L in non-osteoporotic), and there was a statistically significant and positive correlation between BMD & ALP (r=0.487, p=0.013). CONCLUSIONS: There is a positive correlation between BMD and osteogenic potential derived from MSCs. The measurement of BMD can provide supplementary data for evaluating osteogenic potential clinically.

Effects of AG60 on Gastric Chief Cells of the Mouse Implanted with Ehrlich Carcinoma Cells / 대한해부학회지

This experiment was performed to evaluate the morphological responses of the gastric epithelial cells and the gastric chief cells of the mouse inoculated with Ehrlich carcinoma cells in the inguinal area following administration of acriflavine-guanosine composition (AG60). Healthy adult ICR mice were divided into normal and experimental groups. In the experimental groups, each mouse was inoculated with 1x10(7) Ehrlich carcinoma cells subcutaneously in the inguinal area. The day following the 7th injection of saline or AG60, each mouse was injected with methyl-3H-thymidine through tail vein. Seventy minutes after the thymidine injection, gastric tissues were taken and fixed in 10% buffered neutral formalin. Deparaffinized sections were coated with autoradiographic emulsion EM-1 and dried, and then placed in a light-tight box. The number of labeled epithelial cells in the gastric mucosae were observed and calculated. And for electron microscopic observation, gastric tissues were prefixed with 2.5% glutaraldehyde-1.5% paraformaldehyde solution, followed by post-fixation with 1% osmium tetroxide solution. The ultrathin sections were stained with uranyl acetate and lead citrate. The size of zymogen granules and mitochondria in the gastric chief cells were observed and calculated. On the autoradiographic study, number of labeled cells in the area of 3.5 mm width (6 micrometer thickness) of mouse gastric mucosae of normal control, tumor control and AG60-treated groups were 319.7+/-66.46, 343.7+/-47.72 and 102.3+/-54.99 respectively. On the electron microscopic study, the size of zymogen granule in the gastric chief cells of normal control, tumor control and AG60-treated groups were 0.74+/-0.208 micrometer, 1.18+/-0.291 micrometer and 0.97+/-0.259 micrometer, respectively. And the mitochondrial size of the gastric chief cells of normal control, tumor control and AG60-treated groups were 0.86+/-0.364 micrometer, 1.02+/-0.466 micrometer and 0.92+/-0.390 micrometer, respectively. And in the AG60 treated group, most chief cells did not show any difference in ultrastructure, except that myelin figures were more frequently observed, in comparison with that of nornmal control group. From the above results, AG60 may suppress the DNA synthesis of the gastric epithelial cells, but does not results severe fine structural defect on the gastric chief cells. These results suggest that AG60 is expected as one of the most effective anticancer drugs.

Total Hip Arthroplasty using a Ceramic on Ceramic Bearing Surfaces / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical and radiological results of total hip arthroplasty using a ceramic on ceramic bearing surfaces. MATERIALS AND METHODS: From April 1999 to April 2005, 53 hips had total hip arthroplasty with a ceramic on ceramic bearing surfaces in our hospital. Causes of total hip arthroplasty were avascular necrosis of femoral head in 47 hips, osteoarthritis in 3 hips and ankylosing spondylitis in 3hips. We used three kinds of acetabular cup and two kinds of femoral stem in this study. Follow-up period was an average of 55months (24-92). Clinical results were evaluated with Harris hip score and squeak sound. Radiological results included liner wear rate, breakage of ceramic, component loosening and osteolysis. RESULTS: Mean Harris hip scores improved from 58 to 88.3. No breakage of ceramic liner or head occurred. No acetabular or femoral osteolysis was seen. Audible squeak sound or sensation was detected in 10 hips (18%). Revision was done in three cases (5.7%), the cause of one of them was acetabular cup loosening. CONCLUSION: Total hip arthroplasty with a ceramic on ceramic bearing surfaces showed satisfactory clinical and radiological results in an average of 4.6 years follow-up. However, we have to study causes and adverse effect of squeaking on the total hip arthroplasty.

Morphological Study of Respiratory Portion of Mouse Lung following Chemical Glue-Vapor Inhalation / 대한해부학회지

Industrial glues contain many kinds of organic solvents and glue sniffing by young people has become a social problem in Korea. Glue vapor may induce chronic toxicities different from those induced by exposures to the solvent of single component. We studied the effects of the inhalation of glue vapor on the primary target organ, the pulmonary epithelium of the respiratory system. Vapor samples of glue were collected for analysis; the components were acetone, n-hexane, methyl cyclopentane, c-hexane, and toluene. For the inhalation of glue vapor, experimental mice were exposed in a whole body chamber for 20 min/d for 3, 5, 7, and 14 d. Control groups were exposed to room air. Animals were euthanized and lung tissues were fixed in 10% neutral formalin for light microscopy, and in 2.5% glutaraldehyde plus 1.5% paraformaldehyde for electron microscopy. The results are as follows. 1. Alcianophilic bands were not detected in the normal alveolar epithelium, but weak alcianophilic bands were detected in bronchioles. Alcian blue-PAS and PAS positive cells were found in the mucosae of mice exposed to glue vapor for 5 and 7 d. 2. Types I and II pneumocytes and capillary endothelial cells were found in the normal alveolar epithelium. The blood-air barrier consists of Type I pneumocytes, a common basal lamina, and the capillary endothelium. 3. The alveolar epithelium of vapor-exposed mice showed more type II pneumocytes. In the longerexposed group, Type I pneumocytes and endothelial cells contained many pinocytotic vesicles. 4. The vapor-exposed lungs showed macrophages in the alveolar space, mild interstitial swelling, and increased numbers of collagenous fibers. Clearly, ultrastructural changes in pulmonary epithelia can occur following glue sniffing.

Posterior Lumbar Intebody Fusion with Unilateral Transpedicular Screw and Contralateral Translaminar Facet Screw Fixation in Lumbar Spinal Stenosis / 대한척추외과학회지

STUDY DESIGN: A retrospective study. OBJECTIVES: To describe the surgical procedure and assess the results of an unilateral transpedicular screw and contralateral translaminar facet screw fixation in degenerative lumbar stenosis. SUMMARY OF LITERATURE REVIEW: A drawback of conventional lumbar fusion is the extensive soft-tissue destruction that is essential when inserting a screw and preparing the fusion bed. The development of a procedure that minimizes the tissue trauma without compromising the effectiveness of the conventional posterior lumbar interbody fusion (PLIF) should be pursued in lumbar spinal stenosis. MATERIALS AND METHODS: From August 2004 to November 2005, PLIF was performed on 25 consecutive patients who had lumbar spinal stenosis. Among them, 10 patients underwent with unilateral transpedicular screw and contralateral translaminar facet screw fixation (Group 1), and 15 patients underwent traditional bilateral transpedicular screw fixation (Group 2). The clinical and radiological results in the two groups were compared. RESULTS: The mean follow-up was 17.6 and 20.5 months in Groups 1 and 2, respectively. Group 1 had less blood loss, fewer transfusion requirements (P.0.05) in the surgical procedure, and less postoperative back pain (P.0.05). There was no significant difference between the two groups in the clinical results such as the VAS score for back pain and the Kirkadly-Willis criteria at the last follow-up, and the radiological results such as the changes in the disc height and interbody fusion. CONCLUSION: The PLIF with unilateral transpedicular screw and contralateral translaminar facet screw fixation in lumbar spinal stenosis has advantages over conventional PLIF of less soft tissue injury, and produces good clinical results.