Determinants Analysis of Satisfaction with Supporting System for Hearing Aids / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hearing disability has a negative impact on the psychological condition and the quality of life of patients, as well as their daily lives. This study tries to identify the relationship between personal perception of the national supporting system for hearing aids and the satisfaction of the supporting system on the part of users, suppliers and specialists. SUBJECTS AND METHOD: A total of seven questions were developed to identify factors that can affect the satisfaction of national supporting system for hearing aids. We surveyed hearing aids users, suppliers, and specialist; the final sample included 455 subjects. RESULTS: Determinants of satisfaction were adequacy of accepted durability of hearing aids, accessibility to relevant information, necessity of graded financial support by type of hearing aids, necessity of supporting repair cost and necessity of graded financial support by kind of disability rating. According to the results of multiple logistic regression analysis, subjects who answered that accepted durability of hearing aids [odd ratio (OR): 2.03, confidence interval (CI): 1.14-3.60] and accessibility to information (OR: 4.82, CI: 2.65-8.78) were proper showed tendency to be satisfied with support system for hearing aids. The subjects who answered that graded financial support by kind of hearing aids (OR: 1.98, CI: 1.10-3.59) and graded financial support by kind of disability rating (OR: 1.91 CI: 1.07-3.42) were necessary showed tendency to satisfy with support system for hearing aids. CONCLUSION: In order to enhance satisfaction in stakeholder perceptions of supporting system for hearing aids, the system needs provide users with better access to relevant information and help in the use and management of the hearing-aid device.

Is Pediatric Otitis Media Correlated with an Increased Risk of Bronchial Asthma?: An II-Year Nationwide Population-Based Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pediatric otitis media is closely related to upper respiratory illness and is one of the most common causes of hospital visiting and antibiotic prescription. Although there are many studies of asthma with other upper respiratory tract infections, few studies have investigated the relationship between asthma and otitis media. This study estimated whether pediatric otitis media is associated with the risk of asthma using the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC 2002-2013) data. SUBJECTS AND METHOD: In using the NHIS-NSC 2002-2013 data, children diagnosed as otitis media or bronchial asthma in 2002 were excluded from children from 1 to 8 years old in 2003. The patients who were diagnosed and treated as otitis media (n=8506) and the comparison group (n=65886) were enrolled in 2003. During a 10-year follow-up period until December 2013, the incidence of asthma between two groups was analyzed and the result was adjusted for the impact of comorbidities such as atopic dermatitis, allergic rhinitis with multivariate linear regression analyses. RESULTS: In 2003, 20.88% of first-year-old children were treated with otitis media. The prevalence of otitis media was maintained at 15% until age 4 and decreased rapidly after 5 years of age. Asthma incidence was reported higher in patients with otitis media compared to the comparison group, with an adjusted odds ratio of 1.196 [95% confidence interval (CI) 1.127-1.269] followed by patients with atopic dermatitis [hazard ratio (HR) 1.261, 95% CI 1.196-1.33], allergic rhinitis (HR 1.473, 95% CI 1.409-1.54). CONCLUSION: Pediatric otitis media appeared to be associated with an increased risk of developing bronchial asthma after adjusting for other risk factors.

Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

PURPOSE: We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. MATERIALS AND METHODS: Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. RESULTS: Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. CONCLUSION: Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility.

Effect of Low Dose External Irradiation on MMP-2 Expression in Rat Carotid Artery Injury Model

BACKGROUND AND OBJECTIVES: Brachytherapy is one of the promising therapeutic strategy for the prevention of restenosis. The effects of low dose irradiation (<10 Gy) on neointimal hyperplasia, and on the expression of MMP-2 are unknown. MATERIALS AND METHODS: Sprague-Dawley rats were subjected to a balloon injury to the common carotid artery. An external irradiation dose of 10 Gy was performed on the irradiated group at 24 hours following the balloon injury. The index of neointima, such as the percentage area of stenosis, maximal intimal thickness and intima/media area ratio in the H/E stain, were measured, as was the MMP-2 positivity (100xMMP-2(+) cell number/total cell number) from the immunohistochemical staining, at 15 and 29 days following injury. Western blotting for the MMP-2 were performed at 2, 4, 9, 15 and 29 days following injury. RESULTS: The percentage area of stenosis (22.3+/-10.9% vs. 40.2+/-12.1%), maximal intimal thickness (0.11+/-0.06 mm vs. 0.30+/-0.12 mm) and intima/media area ratio (61.7+/-25.8% vs. 127.4+/-65.8%) were lower in the irradiated group at 15 days following injury (p<0.05). At 29 days following injury, there were no differences between the two groups for the above mentioned indices: 57.4+/-14.0% vs. 45.5+/-2.1%; 0.45+/-0.11 mm vs. 0.41+/-0.12 mm and 158.1+/-24.5% vs. 187.8+/-101.9%, respectively (p=NS). The MMP-2 levels in the control group were higher than those in the irradiated group at 15 days (1.03+/-0.69 vs. 1.61+/-0.55, p<0.05), but the levels in the irradiated group were higher than those in the control group at 29 days following injury (1.16+/-0.28 vs. 0.72+/-0.28, p<0.05). There were no differences in MMP-2 positivity between the two groups at 15 days following injury (95.6+/-4.4% vs. 93.1+/-3.5%, p=NS). At 29 days after injury, the MMP-2 positivity was higher in the irradiated than the control group (69.4+/-9.0% vs. 24.6+/-9.9%, p<0.05). CONCLUSION: 10 Gy of external irradiation transiently inhibited the neointimal hyperplasia, partly due to the transient inhibition of the MMP-2 activity in our rat carotid artery injury model.

The Accuracy of Aortic Valve Area Determined by Transesophageal Echocardiography using Direct Planimetry According to the Changes of Cardiac Output and Left Ventricular Ejection Fraction

> BACKGROUND: The accuracy of flow-related changes in aortic valve area (AVA) determined by the Gorlin formula or the continuity equation remains disputable. However, anatomic AVA can be determined by using by direct planimetry of transesophageal echocardiography (TEE). The purpose of this study was to assess the impact of changes in flow on AVA determined by TEE using direct planimetry. METHOD: Determination of AVA by TEE using direct planimetey was performed intraoperatively under three different hemodynamic conditions - pre-dobutamine (baseline) period, post-dobutamine period, post-CABG period - in 17 CABG patients and cardiac output (CO) with left ventricular ejection fraction (EF) were also determined by TEE simutaneously. The changes in aortic flow were induced by dobutamine infusion. RESULTS: AVA at pre-dobumaine period, post-dobutamine period, and post-CABG period were 2.99+/-0.80 cm2, 3.01+/-0.79 cm2, and 3.01+/-0.80 cm2, respectively. Before dobutamin infusion, CO and EF were 2.01+/-0.64 L/min and 47+/-10%. After dobutamine infusion, CO and EF were 3.03+/-1.05 L/min, 54+/-9% respectively and significantly increased by 54%, 18% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. After CABG, CO and EF were 3.86+/-1.86 L/min and 58+/-11% and also significantly increased by 98%, 26% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. However, despite of these significant hemodynamic changes, there were no significant changes in AVA and no significant correlations between these hemodynamic and AVA changes, neither at post-dobutamine period nor post-CABG period. CONCLUSION: The acute changes in CO and EF do not result in significant alterations in the anatomic AVA determined by TEE using direct planimetry. Thus, TEE using direct planimetry could be accurate and useful in the determination of AVA in hemodynamically unstable patient.

The Accuracy of Aortic Valve Area Determined by Transesophageal Echocardiography using Direct Planimetry According to the Changes of Cardiac Output and Left Ventricular Ejection Fraction

> BACKGROUND: The accuracy of flow-related changes in aortic valve area (AVA) determined by the Gorlin formula or the continuity equation remains disputable. However, anatomic AVA can be determined by using by direct planimetry of transesophageal echocardiography (TEE). The purpose of this study was to assess the impact of changes in flow on AVA determined by TEE using direct planimetry. METHOD: Determination of AVA by TEE using direct planimetey was performed intraoperatively under three different hemodynamic conditions - pre-dobutamine (baseline) period, post-dobutamine period, post-CABG period - in 17 CABG patients and cardiac output (CO) with left ventricular ejection fraction (EF) were also determined by TEE simutaneously. The changes in aortic flow were induced by dobutamine infusion. RESULTS: AVA at pre-dobumaine period, post-dobutamine period, and post-CABG period were 2.99+/-0.80 cm2, 3.01+/-0.79 cm2, and 3.01+/-0.80 cm2, respectively. Before dobutamin infusion, CO and EF were 2.01+/-0.64 L/min and 47+/-10%. After dobutamine infusion, CO and EF were 3.03+/-1.05 L/min, 54+/-9% respectively and significantly increased by 54%, 18% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. After CABG, CO and EF were 3.86+/-1.86 L/min and 58+/-11% and also significantly increased by 98%, 26% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. However, despite of these significant hemodynamic changes, there were no significant changes in AVA and no significant correlations between these hemodynamic and AVA changes, neither at post-dobutamine period nor post-CABG period. CONCLUSION: The acute changes in CO and EF do not result in significant alterations in the anatomic AVA determined by TEE using direct planimetry. Thus, TEE using direct planimetry could be accurate and useful in the determination of AVA in hemodynamically unstable patient.

A Case of Isolated Protein S Deficiency, complicated by Acute Pulmonary Thromboembolism after Coronary Angiography

No abstract available.