Non-flammable Gel Polymer Electrolyte for Enhancing the Safety and High-Temperature Performance of Lithium-Ion Batteries.

As the applications of lithium-ion batteries (LIBs) have expanded, battery safety has emerged as a major concern because of the thermal runaway of LIBs arising from the use of flammable liquid electrolytes (LEs). Gel polymer electrolytes (GPEs) have been considered as potential candidates to replace LEs and improve the thermal safety of LIBs. In our study, a chemically cross-linked nonflammable GPE was synthesized and used in an LIB. A cross-linking agent, spirocyclic pentaerythritol diphosphate perfluorinated ether acrylate, comprising a phosphorus moiety and a fluoroether chain, was designed and synthesized to prepare a nonflammable cross-linked GPE. The obtained GPE effectively suppressed the deleterious reactions of the LE and imparted nonflammable characteristics. The pouch-type graphite/LiNi0.6Co0.2Mn0.2O2 cell with a nonflammable GPE delivered an initial discharge capacity of 146.7 mAh g-1 with a capacity retention of 71.1% after 300 cycles at 0.5 C and 55 °C. Moreover, the chemically cross-linked GPE exhibited excellent dimensional and thermal stability, which allowed for the safer operation of LIBs even under harsh conditions. This work provides guidelines for designing nonflammable electrolyte systems for advanced LIBs with high safety, enhanced thermal stability, and good cycling characteristics at elevated temperatures.

The Relationship Between Zonulin and Asthma: A Mouse Model Study

Background and Objectives@#Zonulin is a human protein that regulates intercellular tight junctions and increases the permeability of the intestinal epithelium. In light of the increasing focus on zonulin’s role in numerous chronic inflammatory diseases, this study aimed to investigate whether differences exist in serum zonulin levels and bronchial epithelium zonulin expression in vivo between asthma and normal groups, using a mouse model. @*Methods@#Sixteen mice were utilized in this study, divided evenly between the normal and asthma groups. Serum zonulin levels, the expression of zonulin antibody in the bronchial epithelium, and serum cytokine levels were evaluated in both groups. Enzyme-linked immunosorbent assay and RNA in situ hybridization were utilized for the analysis. @*Results@#The asthma group exhibited significantly higher levels of serum zonulin. High zonulin antibody expression was also observed in the bronchial epithelium of the asthma group. Given that our mouse model demonstrated a significant difference in interleukin (IL)-4 and IL-6 between the normal and asthma groups, zonulin may be associated not only with type 2 responses but also with various subtypes of asthma. Further studies are required to investigate this relationship in greater detail. @*Conclusion@#Zonulin may play a role in the complex pathophysiology of asthma and could serve as a biomarker in various asthma-related situations.

Cathode Electrolyte Interphase-Forming Additive for Improving Cycling Performance and Thermal Stability of Ni-Rich LiNixCoyMn1-x-yO2 Cathode Materials.

High-capacity Ni-rich LiNixCoyMn1-x-yO2 (NCM) has been investigated as a promising cathode active material for improving the energy density of lithium-ion batteries (LIBs); however, its practical application is limited by its structural instability and low thermal stability. In this study, we synthesized tetrakis(methacryloyloxyethyl)pyrophosphate (TMAEPPi) as a cathode electrolyte interphase (CEI) additive to enhance the cycling characteristics and thermal stability of the LiNi0.8Co0.1Mn0.1O2 (NCM811) material. TMAEPPi was oxidized to form a uniform Li+-ion-conductive CEI on the cathode surface during initial cycles. A lithium-ion cell (graphite/NCM811) employing a liquid electrolyte containing 0.5 wt % TMAEPPi exhibited superior capacity retention (82.2% after 300 cycles at a 1.0 C rate) and enhanced high-rate performance compared with the cell using a baseline liquid electrolyte. The TMAEPPi-derived CEI layer on NCM811 suppressed electrolyte decomposition and reduced the microcracking of the NCM811 particles. Our results reveal that TMAEPPi is a promising additive for forming stable CEIs and thereby improving the cycling performance and thermal stability of LIBs employing high-capacity NCM cathode materials.

Phonon-Suppressing Intermolecular Adhesives: Catechol-Based Broadband Organic THz Generators.

Solid-state molecular phonons play a crucial role in the performance of diverse photonic and optoelectronic devices. In this work, new organic terahertz (THz) generators based on a catechol group that acts as a phonon suppressing intermolecular adhesive are developed. The catechol group is widely used in mussel-inspired mechanical adhesive chemistry. Newly designed organic electro-optic crystals consist of catechol-based nonlinear optical 4-(3,4-dihydroxystyryl)-1-methylpyridinium (DHP) cations and 4-(trifluoromethyl)benzenesulfonate anions (TFS), which both have multiple interionic interaction capability. Interestingly, compared to benchmark organic crystals for THz generators, DHP-TFS crystals concomitantly achieve top level values of the lowest void volume and the highest crystal density, resulting in an exceptionally small amplitude of solid-state molecular phonons. Simultaneously achieving small molecular phonon amplitude, large optical nonlinearity and good phase matching at infrared optical pump wavelengths, DHP-TFS crystals are capable of generating broadband THz waves of up to 16 THz with high optical-to-THz conversion efficiency; one order of magnitude higher than commercial inorganic THz generators.

Newborn Periventricular Nodular Heterotopia with Persistent Feeding Cyanosis and Apneic Spell: A Case Report

Periventricular nodular heterotopia (PNH) is a neuronal migration disorder that occurs during early brain development. Patients with PNH may be asymptomatic and have normal intelligence; however, PNH is also known to cause various symptoms such as seizures, dyslexia, and cardiovascular anomalies. PNH is not commonly diagnosed during early infancy because of the lack of clinical manifestations during this period. We present the case of a female infant diagnosed with PNH based on brain magnetic resonance imaging, who had symptomatic patent ductus arteriosus that had to be ligated surgically and had prolonged feeding cyanosis with frequent apneic spells.

Successful Transcatheter Arterial Embolization following Diverticular Bleeding in the Third Portion of the Duodenum:A Case Report

This is a rare case of a 73-year-old male patient who presented with hematochezia and was treated using transcatheter arterial embolization following upper gastrointestinal bleeding in the third portion of the duodenum. The cause of the bleeding was not found on gastrointestinal endoscopy and CT. On the third day of hospitalization, the hemoglobin level continued to decrease. A technetium-99m-labeled red blood cell scan revealed suspicious bleeding in the diverticulum of the third portion of the duodenum. Superior mesenteric artery angiography showed active bleeding from the posteroinferior pancreaticoduodenal artery, which was embolized with N-butyl cyanoacrylate. The patient was discharged on the seventh day after embolization without re-bleeding or complication. We report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. Herein, we report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. We also conducted a relavant literature review.

Iatrogenic Iliac Vein Injury Following Extracorporeal Membrane Oxygenation Cannulation in a Patient with May-Thurner Syndrome: A Case Report and Literature Review

A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient’s vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.

Full Color Tunable Aggregation-Induced Emission Luminogen for Bioimaging Based on an Indolizine Molecular Framework.

By taking advantage of a unique mechanism of aggregation-induced emission (AIE) phenomena, AIE luminogens (AIEgens) have been provided as a solution to overcome the limitations of conventional fluorophores bearing the feature of aggregation-caused quenching (ACQ) phenomena. Especially, AIEgens paved the way to develop fluorogenic probes ideal for fluorescent imaging in live cell conditions. Despite the high demand for discovery of new AIEgens, it is still challenging to find a versatile molecular platform to generate diverse AIEgens. Herein, we report a new colorful molecular framework, Kaleidolizine (KIz), as a molecular platform for AIEgen generation. The KIz system allows systematic tuning of the emission wavelength from 455 to 564 nm via perturbation of the electron density of substituents on the indolizine core. Increasing the water fraction of the KIz solution in the THF/water mixture induces the fluorescence intensity increase up to 120-fold. Crystal structure analysis, computational calculations, and solvatochromism studies suggest that a synergistic effect between the intramolecular charge transfer and restriction of intramolecular rotation acts as the AIE mechanism in the KIz system. Conjugation of the triphenylphosphonium moiety to KIz allows successful development of triphenylphosphonium (TPP)-KIz for real-time bioimaging of innate mitochondria in live cells, thereby revealing the potential of KIz as a versatile molecular platform to generate fluorogenic probes based on AIE phenomena. We do believe the KIz system could serve as a new, reliable, and generally applicable molecular platform to develop various AIEgens having desired photophysical properties along with an excellent signal-to-noise ratio and with experimental convenience especially for fluorogenic live cell imaging.

Dizzy and Psychological Scales in Benign Paroxysmal Positional Vertigo: Suspicious Patients without Characteristic Nystagmus / 대한평형의학회지

OBJECTIVES: Patients, who have had a history of benign paroxysmal positional vertigo (BPPV)-like symptoms, but no characteristic nystagmus, were often present. They are diagnosed as having a resolved state from BPPV or normal, and tend to be overlooked. We investigated the dizzy and psychological scales in BPPV-suspicious patients. METHODS: Thirty-nine patients, which they had vertigo of a short duration at the specific head position, and clinically suspicious BPPV, but no nystagmus in positional tests, were enrolled. We compared dizzy and psychological scales of suspicious BPPV patients with 138 BPPV patients, using dizziness handicap inventory (DHI), the beck depression inventory (BDI), and the Spielberger state-trait anxiety inventory. Additionally, among the BPPV-suspicious group, patients with a BPPV history were compared with those with no previous BPPV. RESULTS: No differences in the all scales were found between the two groups. However, DHI scores of patients with a previous BPPV attack were significantly higher than those of patients with no BPPV-like symptoms; in particular, there was a significant difference in emotional scores. CONCLUSION: Although the patients had no characteristic nystagmus, if they have a BPPV-like history and symptoms, emotional support and periodic follow up are needed. In particular, careful observation should be performed in patients with previous BPPV attack.

Analysis of Voice and Swallowing Symptoms after Thyroidectomy in Patients without Recurrent Laryngeal Nerve Injury in Early Postoperative Period

BACKGROUND AND OBJECTIVES: After thyroidectomy, many patients experience problems report such things as reduced voice range and vocal fatigue, swallowing problems without superior and recurrent laryngeal nerve injury. The purpose of this study was to evaluate voice and swallowing problems before and after thyroid surgery without laryngeal nerve injury. MATERIALS AND METHODS: Ninety-three patients who underwent thyroidectomy without laryngeal nerve injury and completed the follow-up evaluations were studied between June 2013 and December 2015. Each evaluation was performed preoperatively, as well as 1 week, 1 month postoperatively. Analysis was performed including voice handicap index (VHI), dysphagia handicap index (DHI), and acoustic voice analysis. RESULTS: Patients show significant variation of parameters in the fundamental frequency (F), maximal phonation time (MPT), shimmer, jitter and soft phonation index (SPI) early after operation, and most of them showed recovery of parameters after 1month of operation. Perceptive complaint of voice and swallowing also showed significant decreased after operation (p<0.005). After 1 month of operation, MPT, highest frequency and frequency ranges still showed significant decreased parameters. Comparing acoustic and perceptive parameters of total thyroidectomy and lobectomy, there was no significant changes between them except highest frequency (p=0.042). CONCLUSION: The results from both subjective and objective evaluations show voice and swallowing disturbance after thyroidectomy even in the absence of laryngeal nerve and provide patients information about the recovery process after surgery. Highest frequency parameter showed most significant changes after operation.

A Case of Nasal Cavity Foreign Bodies by Inhalation of Polyurethane Foam

Foreign bodies in the nasal cavity are commonly encountered in otorhinolaryngologic practice, particularly among children and mentally handicapped patients. Such foreign bodies include plastic toys, pebbles, seeds, buttons, and many others. Many of these foreign bodies can be easily removed with simple tools. However, some of them adhere to the nasal mucosa, resulting in complications such as necrosis or neurovascular injury of the nasal mucosa. Polyurethane foam in the nasal cavity has never been reported in Korea. Furthermore, the complications caused by polyurethane foam in the nasal cavity have not yet been reported. In this article, we report a man who presented with polyurethane foam that had spread into both nasal cavity and nasopharynx by inhalation and adhered to the nasal cavity and sinuses.

A Case of Tolosa-Hunt Syndrome Presented with Headache, Ptosis and Vision Loss

Cavernous sinus syndrome (CSS) is defined as the involvement of two or more of the third, fourth, fifth (V1, V2) or sixth cranial nerves or involvement of only one of them in combination with a neuroimaging-confirmed lesion in the cavernous sinus. Some cases of CSS are attributed to Tolosa-Hunt syndrome (THS), an idiopathic inflammatory disease of the cavernous sinus. THS is characterized by painful ophthalmoplegia due to granulomatous inflammation in the cavernous sinus. THS is a diagnosis of exclusion that requires a vigorous series of differential diagnoses, and corticosteroid therapy is known to dramatically resolve clinical findings of THS. We report a case of a patient with painful ophthalmoplegia associated with vision loss, which was suspected to be THS. This patient followed a relatively typical clinical course of THS on steroid pulse therapy. We emphasize the differential diagnosis of THS, its presentation, and treatment.

Clinical Analysis of Dizzy Patients with High Levels of Depression and Anxiety

BACKGROUND AND OBJECTIVES: Some patients experiencing dizziness also report psychological distress. However, the association between vestibular deficits and psychological symptoms remains controversial. Thus, the aim of this paper is to report the proportion of patients who complained of dizziness who also had high depression and anxiety indices. Also we investigated the severity of their dizziness and the distribution of the diseases underlying this symptom. SUBJECTS AND METHODS: We assessed the dizziness and psychological distress of 544 patients experiencing dizziness using the Korean versions of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). We also reviewed the audio-vestibular symtoms of patients with high levels of depression and anxiety. RESULTS: The incidences of high depression and anxiety scores were 11% (60/544) and 18% (98/544), respectively. Patients with vestibular migraine were most likely to have high depression and anxiety indices. Patients in the high-BDI or high-STAI groups (117/544) obtained significantly higher DHI scores than those in neither the high-BDI nor the high-STAI group (427/544). We noticed that about 20% of the patients experiencing dizziness had high levels of psychological distress in this study; this group also suffered from various vestibular diseases and more symptoms of dizziness. CONCLUSIONS: The results of the study suggest that psychological evaluation should be considered when assessing patients with vertigo.

Availability of Preoperative Systemic Steroids on Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyposis

PURPOSE: To analyze the outcome of endoscopic sinus surgery (ESS) after preoperative systemic steroid (PSS) treatment for chronic rhinosinusitis (CRS) with nasal polyposis (NP) and to investigate and compare clinicopathological factors associated with the outcome. MATERIALS AND METHODS: We performed a retrospective chart review of 468 patients with CRS with NP who underwent primary ESS between January 2005 and October 2011. 124 patients who met the inclusion criteria were included. Beginning from 2008, our clinic administered steroid preoperatively in patients of CRS with NP, thus there were 84 patients with preoperative systemic steroid (PSS group) and another 40 patients without such regimen (no PSS group). To evaluate the outcome after ESS, poor outcome and complication were analyzed according to the following parameters: age, sex, follow-up duration, eosinophilic infiltration, atopy, asthma, Lund-Mackay score, and polyp grade. RESULTS: There was no significant difference in poor outcome rates between the PSS and no PSS group (35.0% vs. 47.6%, p=0.185). There was no significant difference in complication rates between the PSS and no PSS group (10% vs. 6%, p=0.468). As with the multivariate analysis of the clincopathological factors to the poor outcome rate, presence of asthma and eosinophilic infiltration were significantly related (odds ratio as 6.555 and 4.505, respectively), whereas PSS was confirmed as less likely related (odds ratio 0.611). CONCLUSION: Low dose PSS administration does not seem to have an effect on the outcome after ESS in patients who have CRS with NP. Eosinophilic infiltration and presence of asthma are important predictors of surgical outcome.

Clinical Analysis of High Resolution Manometry (HRM) in Patients with Laryngopharyngeal Reflux Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: High resolution manometry (HRM), a newly developed device that uses 36 channels to plot pressure topography of esophagus, has recently been applied to evaluate the esophageal and upper esophageal sphincter (UES) status; however, its definite role in laryngopharyngeal reflux disease (LPRD) is not well elucidated. The aim of this study was to evaluate clinical usefulness of HRM and to elucidate the association between HRM findings and dysphasia in LPRD patients. SUBJECTS AND METHOD: A total of 56 patients who had been diagnosed LPRD from July 2010 to July 2011 were prospectively enrolled in this study. Patients consisted of 20 men and 36 women, with the mean age of 51.4 years. Every patient performed the questionnaire and HRM examination. A comparative analysis was performed to evaluate the correlation between the HRM results and LPRD. RESULTS: Of 30 patients (53.6%), there were 11 peristaltic dysfunction (19.7%), 6 relaxation impairment of lower esophageal sphincter (LES)(10.7%), 4 diffuse esophageal spasm (7.1%), 4 hypotensive LES (7.1%), 3 Nutcracker esophagus (5.4%), and 2 relaxation impairment of UES (3.6%). The mean distance of UES from the nostril was 17.88+/-2.17 cm and the mean UES basal pressure was 63.10+/-24.49 mm Hg. Differences between the prevalence of abnormal findings shown by HRM and dysphasia symptoms were not statistically significant. CONCLUSION: In this study, a considerable amount of abnormalities in esophageal function were observed using HRM, and thus we think that HRM could provide useful information about esophagus dysfunction in LPRD patients.

Spontaneous Tonsillar Hemorrhage and Post-Tonsillectomy Hemorrhage

Spontaneous tonsillar hemorrhage from infectious causes is extremely rare and post-tonsillectomy hemorrhage, although also relatively rare, is an unavoidable complication of the procedure. Hemorrhage in association with tonsillitis or tonsillectomy is potentially dangerous and can be life threatening. We report here the presentation and management of a 42-yr-old man with severe spontaneous hemorrhage from infected tonsils and post-tonsillectomy hemorrhage. We suggest that if attempts to control the bleeding are not successful or if severe spontaneous tonsillar hemorrhage occurs repeatedly or a malignancy is suspected, tonsillectomy and close postoperative follow up is recommended.

A Clinical Analysis of Psychogenic Hearing Loss Presenting as Sudden Deafness / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden deafness results from, in most cases, lack an apparent cause. However viral infection, vascular occlusion, cochlear membrane rupture, and others are known to be associated with this disease. In this study, we observed incidence, etiology, audiologic, psychiatric, and clinical aspect of psychogenic sudden deafness through retrospective chart review and analysis of patients who are thought to have had sudden deafness from psychogenic causes and stressor. SUBJECTS AND METHOD: We reviewed the records of 277 patients who had been admitted to the Department of Otolaryngology, Kangbuk Samsung hospital, from January 1997 to July 2003, under the initial diagnosis of idiopathic sudden hearing loss. RESULTS: In patients' medical history, there were 9 patients who had association between sudden onset of hearing loss and psychogenic causes and stressor. And there were 4 patients who had preexisting psycho-pathologic condition. Among these patients, a joint study with psychiatrist classified 7 psychogenic sudden deafness patients (2.5%) who has been ruled out organic causes and showed discrepancy between pure tone audiometry and ABR. In distribution ratio, there were 2 males and 5 females, 4 patients were in their 10's, 1 in 20's, and 2 in 40's (24 years old in average), 3 bilaterals, and 4 unilaterals. In hearing test, there were 4 patients with severe to profound hearing loss at 71 dB or higher, 2 patients with moderately severe hearing loss ranged from 56 to 70 dB, and 1 patient with moderate hearing loss from 41 to 56 dB. Hearing ability of all these patients were partially or completely recovered by treatment including steroid injection and joint psychotherapy with psychiatrist. CONCLUSION: About 2.5% of sudden deafness patients were psychogenic sudden deafness patients, and the results showed distinctive features for each of audiologic, psychiatric, and clinical characteristics. The recovery rate and prognosis were better in patients who had cure and diagnosis under consult with department of psychiatry and accurate audiometry.

A Case of Bilateral Facial Nerve Palsy Associated with Infectious Mononucleosis / 대한이비인후과학회지

Infectious mononucleosis, a common systemic illness primarily involving children and young adults, is due apparently to the Epstein-Barr virus (EBV). Although neurologic complications of infectious mononucleosis are rare, these include meningoencephalitis, Guillain-Barre syndrome and mononeuritis, and facial nerve paralysis. Bilateral facial nerve palsy rarely develops in patients with a primary Ebstein-Barr virus (EBV) infection, and only a few of these have clinical manifestations of infectious mononucleosis. We report a case of a 18-year-old man with bilateral facial nerve paralysis associated with infectious mononucleosis.

Two Cases of Pilomatricoma Originated from Auricle and Posterior Neck / 대한이비인후과학회지

Pilomatricomas are rare, usually benign and solitary, asymptomatic, calcifying tumors of the hair matrix cell, which mostly appear in the first and second decade of life. However, they may occur in adulthood. The most prevalent sites of pilomatricomas in children are the head and neck but they may occur anywhere. The typical presentation is a firm, slowly enlarging, freely mobile, well-circumscribed subcutaneous nodule, measuring 0.5 to 3 cm in diameter. The tumors are generally solitary, often adherent to overlying skin. Multiple pilomatricoma is relatively rare. Spontaneous regression is never observed, complete surgical excision is a treatment of choice. We present two cases of pilomatricoma arising from the right posterior auricle and the left posterior neck, which were treated with simple excision.

A Case of Rhino-Orbito-Cerebral Mucormycosis

Rhino-orbito-cerebral mucormycosis is a rare opportunistic invasive fungal infection, with rapid progression and high mortality. It is characterized by an aggressive necrotizing infection spreading from the nose to the paranasal sinuses, orbit, and the brain. This disease is often associated with diabetic ketoacidosis, leukemia, malnutrition, AIDS and immunocompromis ed patients. Typical initial symptoms of a patient with rhino-orbito-cerebral mucormycosis are facial pain and swelling, headache, fever, and blood-tinged rhinorrhea. Symptoms rapidly progressed to facial or orbital cellulitis, proptosis, and visual loss, facial nerve palsy. We report a case report of a 66-year-old woman with poorly controlled diabetes mellitus who developed mucormycosis which involved unilateral paranasal sinus, orbit, and selective cranial nerves.