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BACKGROUND AND OBJECTIVES: A computerized database system could provide benefit to reducing the variability of reporting results of chronic ear surgery, where a variety of factors may influence the outcomes. In the present study, the factors contributing to hearing gains after chronic ear surgery were investigated using a computerized database. MATERIALS AND METHODS: Audiometric data were easily drawn from the database log of 622 surgical cases of chronic otitis media done by one surgeon from 1989 to 1996. Of these, 309 were collected with the inclusion criteria being the period of no shorter than 3 months following tympanoplasty procedures. Post-operative hearing gains were compared according to the patient factor (sex, age), disease factors (unilateral vs bilateral disease, existence of cholesteatoma, preoperative otorrhea), surgery factor (primary versus revision operation, types of mastoidectomy, ossiculoplasty, hearing status of the operated ear), and the surgeon's experience. RESULTS: Pre- and post-operative air-bone gaps of the pure tone averages for the 309 cases studied were 34.6+/-13.4 dBHL and 24.9+/-13.8 dBHL, respectively. The post-operative hearing gains were 9.6+/-13.6 dBHL. The hearing gains did not differ significantly beween the groups when it is compared with regards to the factors, such as sex and age of patients, revision operation, hearing status, surgeon's experience. But the hearing gains differed with regards to the other factors, such as cholesteatoma, otorrhea, mastoidectomy and ossiculoplasty (p<0.05). CONCLUSION: This kind of computerized database is very useful to assess the effect of factors on the hearing gains following chronic ear surgery.
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Humanos , Colesteatoma , Orelha , Audição , Otite Média , TimpanoplastiaRESUMO
All epithelial cells express more than 2 cytokeratins, and their tissue distribution is determined by cellular types, location, and degree of differentiation. It is known that changes in cytokeratin expression accompany squamous metaplasia of the human nasal epithelium. We analysed cytokeratin expression patterns and their significance in normal nasal mucosae, nasal polyps, inverted papillomas, and maxillary squamous cell carcinomas using immunohistochemical staining with anti-CK4, CK8, CK10, CK13, CK17, CK18, and CK19. Nasal polyp showed the same pattern of cytokeratin expression as that of nasal mucosa. While CK10 expression was present only in the tissue of squamous cell carcinoma, CK18 and CK19 were not expressed. Specimens of Inverted papilloma expressed CK4 and CK13 only in the suprabasal layer, and CK17 in the basal and suprabasal layers. In contrast, normal epithelium expressed CK13 and CK17 only in the basal layer, and CK4 in the basal and suprabasal layers. CK8 and CK18 were less expressed in the specimen of inverted papilloma than in the normal nasal mucosa. The expression patterns of CK10 and CK19 suggest that they may play a role in determinating the malignant change of inverted papilloma and in investigating the pathogenesis of inverted papilloma and maxillary cancer.
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Humanos , Carcinoma de Células Escamosas , Células Epiteliais , Epitélio , Queratinas , Metaplasia , Mucosa Nasal , Pólipos Nasais , Papiloma Invertido , Distribuição TecidualRESUMO
No abstract available.
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No abstract available.
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Lack of validity and reliability in selection procedure for internship at teaching hospitals has become a nationwide serious issue, especially regarding its influence on undergraduate medical education. This article describes a case model of selection procedure for internship at Seoul National University Hospital aiming for appropriate measurement of clinical competency as well as a meaningful feedback to the undergraduate medical education. The modification of selection was based on two parts; a problem-based written examination and a clinical skill-attitude assessment. For the former, a total of 60 test items for 34 problem cases were developed, being provided with a variety of pictorials and figures to simulate a real clinical setting. The knowledge level of all test items were either interpretation or problem-solving, and multi-answer items were randomly included to minimize a risk of high chance scoring in multiple choice items. The clinical skill was assessed with 10 important skills with predesigned check list. We conclude that problem-oriented written examination together with clinical skill assessment is a way of improving the measurement of clinical competency and strengthens clinical clerkship effectively during the undergraduate clinincal studies.