A survey of chikungunya virus in brain tissue samples from rat like animals in Xiamen, Shenzhen and Guangzhou / 实用医学杂志

Objective To examine the prevalence of chikungunya virus in brain tissue samples from rat?like animals in Xiamen, Shenzhen and Guangzhou, and to explore whether the rat?like animals are potential sources of human chikungunya fever infections and the host of the virus. Methods Rat?like animals were trapped in residential areas, city parks, hospitals, markets and schools in Xiamen, Shenzhen and Guangzhou (Yuexiu and Baiyun districts) between January 2013 and June 2016. Brain tissue samples of the trapped animals were collected under sterile. Chikungunya virus was detected by using reverse transcription polymerase chain reaction (RT?PCR). Results Totally 1092 rat?like animals were trapped, which belonged to 7 species, 3 genera, 2 families, 2 orders. Rattus norvegicus was the dominant species in the indoor environment, Rattus losea was dominant in wild environment, and 1092 brain tissue samples were collected. No detectable chikungunya virus was found in the brain tissue samples by RT?PCR. Conclusion There is a low possibility that rat?like animals act infectious sources of human chikungunya fever infections and the host of the virus.

Sleep Problems and Daytime Sleepiness in Children with Nocturnal Enuresis

PURPOSE: Nocturnal enuresis (NE) is one of the most common problems in childhood. NE has a multifactorial etiology and is influenced by sleep and arousal mechanisms. The aim of the present study was to prospectively evaluate sleep problems and patterns in children with NE compared with normal healthy controls. METHODS: Twenty-eight children with NE and 16 healthy controls were included in the study. To evaluate sleep habits and disturbances, parents and children filled out a questionnaire that included items about sleep patterns and sleep-related behaviors prior to treatment for NE. Demographic factors and other data were compared for the two groups based on the responses to the sleep questionnaire. RESULTS: Night awakening, sleepwalking, and periodic limb movements were more prevalent in children with NE, but symptoms of sleep-disordered breathing were not increased in this group. There were statistically significant differences in periodic limb movements and daytime sleepiness between the two groups. CONCLUSION: Children with NE seemed to have more sleep problems such as night awakening, sleepwalking, and periodic limb movements. In addition, a higher level of daytime sleepiness and hyperactivity in patients with NE suggested a relationship between NE and sleep disorders.

Normal Polysomnographic Characteristics in Korean Children and Adolescents / 대한소아신경학회지

PURPOSE: The objective of this study was to describe polysomnographic charateristics in normal children and adolescents in Korea. Little is known regarding sleep architecture in Korean children. METHODS: We conducted a prospective study and examined sleep architecture, respiratory parameters, arousals, and periodic limb movement index during sleep (PLMS) in healthy children and adolescents for 2 consecutive days. RESULTS: The study population consisted of 29 subjects and 15 subjects (52%) were male. Ages ranged from 5-16 years, with a mean of 11.6+/-.7 years. The average total sleep time (TST) was 438+/-35.6 min, and the mean sleep efficiency was 90.9+/-17.7%. The distribution of sleep stages as percentage of TST was as follows: stage N1, 6.6+/-2.9%; stage N2, 54.2+/-5.8%; stage N3, 21.1+/-6.7%; and stage R, 18.1+/-5.4%. The wake after sleep onset (WASO) was 2.0+/-2.9% of TST. The total arousal index (TAI) was 7.6+/-2.2. The current study findings are similar to those of previous studies in Western countries except longer stage N2 sleep and higher WASO. CONCLUSION: This is the first report of normal polysomnography values in Korean children. In order to accurately diagnose sleep disorders, normative sleep reference values are essential and our findings will provide fundamental data for pediatric sleep research.

Relation between serum Apelin level and insulin resistance in infertility patients with polycystic ovarian syndrome / 实用医学杂志

Objective To explore the change of serum Apelin level and its relationship with insulin resistance (IR) in infertility patients with polycystic ovarian syndrome (PCOS). Methods Ninety-eight infertility patients with PCOS (PCOS group) and 72 infertility patients without PCOS (non-PCOS group) visiting our hospital for the first time from January 2011 to June 2012 were selected. The BMI , serum Apelin level (detected by ELISA), fasting blood glucose (FPG, detected by glucose oxidase method), fasting insulin (Fins, detected by chemiluminescence), and homeostasis model assessment of insulin resistance index (HOMA-IR) of the two groups were detected. Results The serum Apelin level and HOMA-IR in PCOS patients were higher than those in non-PCOS patients (3.28 ± 1.24 vs. 1.94 ± 0.78, P < 0.05; 3.84 ± 1.23 vs. 2.14 ± 0.77,P < 0.05). Pearson correlation analysis showed that serum Apelin level was positively correlated with HOMA-IR in PCOS patients (r=0.65, P<0.01). Conclusions The serum Apelin level in infertility patients with PCOS increased evidently, and was positively correlated with HOMA-IR; which indicated that Apelin may involve in the development of IR in infertility patients with PCOS.

Retraction: Systematized Intraoperative Facial Nerve Monitoring in Middle Ear and Mastoid Surgery; 'Surgical Dehiscence' and 'Electrical Dehiscence' / 대한이비인후과학회지

No abstract available.

Retraction: The Effects of Intratympanic Steroid Injection for the Patients with Refractory Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

No abstract available.

The change trend of mother-to-child transmission rate of HIV-1 during 2005-2007 in some areas of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the change trend of mother-to-child-transmission (MTCT) of HIV-1 in some areas in China.</p><p><b>METHODS</b>The investigation was conducted in 15 counties or districts of 4 provinces in China with relatively high HIV prevalence from January 2005 to June 2009. The data on the death and HIV-status of the babies born to HIV-positive mothers from January 2005-December 2007 in research sites were collected through 18-month following up after they were born.</p><p><b>RESULTS</b>During the time that the research was conducted, there were 644 babies born to HIV-positive mothers who were followed up for 18 months. At the end of 18 months, full data were collected from 550 babies, 44 babies were lost to follow-up and 50 babies died. Among 550 babies who were followed up for 18 months, 53 babies were confirmed as HIV positive. The rate of MTCT of HIV-1 was 13.19% (24/182), 8.90% (17/191) and 6.78% (12/177) in 2005, 2006, 2007 respectively, which showed a descending trend yearly (chi(2) = 4.23, P < 0.05). Adjusted by the death data of the HIV-exposed children, it was found that during 2005-2007 the rate of MTCT of HIV-1 was 16.74%, 12.98%, 9.52% respectively, which was also descending year by year (chi(2) = 4.69, P < 0.05).</p><p><b>CONCLUSION</b>Long-term, effective prevention of mother-to-child-transmission of HIV (PMTCT) could reduce the level of MTCT of HIV-1 year-by-year. In addition, using death data of HIV-exposed children to adjust the level of MTCT of HIV-1 is valuable to grade the effect of PMTCT.</p>

Two Cases of Artificial Auricular Reconstruction Using an Epithese / 대한이비인후과학회지

One of the most common uses of osseointegration has been to supply patients with craniofacial defects with a bone-anchored epitheses (BAE). BAEs are usually used in the craniofacial defects such as congenital external ear anomalies or facial defects after cancer surgeries or trauma. We report a case of a 26 year-old woman with traumatic auricular amputation due to a traffic accident 4 years ago and a case of 23 year-old man with congenital ear deformity. They took osseointegrated implantations for an auricular prosthesis and are using it without complications. BAEs can be used with good functional and esthetic outcome for artificial auricular reconstruction.

Systematized Intraoperative Facial Nerve Monitoring in Middle Ear and Mastoid Surgery: 'Surgical Dehiscence' and 'Electrical Dehiscence' / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The use of intraoperative facial nerve monitoring (IOFNM) improves facial nerve outcomes in acoustic neuroma surgeries, but the role of IOFNM in middle ear and mastoid surgeries is poorly defined. This study was performed to evaluate the role of IOFNM in middle ear and mastoid surgeries and to systemize IOFNM. SUBJECTS AND METHOD :We carried out a prospective study of 83 patients who undertook middle ear and mastoid surgeries with IOFNM. We checked the facial nerve dehiscence and estimated its location and length using a surgical microscope ('surgical dehiscence'). We stimulated the facial nerve with constant current, unipolar stimulation using Nerve Integrity Monitor (NIM)-2(TM) (Xomed (TM), U.S.A.) and estimated the minimal threshold of electric current making the electromusculography of facial muscle changes. RESULTS: Thirty six (43.4%) of 83 cases showed 'surgical dehiscence' and all responded to 0.7 mA or less of electrical stimulation. The most common site of 'surgical dehiscence' was middle portion of the tympanic segment. We defined the response to electrical stimulation within 0.7 mA as 'electrical dehiscence.' 'Electrical dehiscence' was presented in 63 (75.9%) cases and 82.5% of these cases responded to stimulation of 0.4 mA or less. The mean threshold of minimal electrical stimulation was 0.28 mA for tympanic segment and 0.48 mA for mastoid segment. CONCLUSION: "Electrical dehiscence" based on responses of electrical stimulation is safer than "surgical dehiscence," which is based on microscopic observation in middle ear and mastoid surgery. Based on this study, we recommend the electrical stimulation of 0.7 mA for first screening and 0.4 mA for second exploration in defining facial nerve using intraoperative NIM-2(TM) monitoring in middle ear and mastoid surgeries.

Clinical Analysis of Orbital Complications of Acute Sinusitis according to Age

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.

The Effects of Intratympanic Steroid Injection for the Patients with Refractory Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: High-dose steroid therapy has been known as the treatment of choice for sudden sensorineural hearing loss (SSNHL). However, about one third of patients do not generally respond to any treatments, and there seem to be no definitive treatment for the patients with refractory SSNHL. We prospectively studied the effect of intratympanic steroid injection (ITSI) for patients with refractory SSNHL. SUBJECTS AND METHOD: Sixty six patients with SSNHL, who were refractory to a course of oral steroid therapy, were included in this study. Thirty three patients (34 ears) were treated with ITSI and the other 33 patients had no further treatments as control. ITSI was performed with dexamethasone in the supine position on 4 separate occasions over the course of 2 weeks. Hearing was assessed immediately before every injection, and at 1 and 4 weeks after therapy. Hearing improvement was defined as more than 10 dB in pure tone average (PTA). RESULTS: Hearing improvement was observed in 13 (39.4%) of 33 patients who underwent ITSI and in 2 (6.1%) of 33 patients in control group. Five of 13 showed hearing improvement over 20 dB in PTA, and 11 of 20 patients showed no improvement in PTA by ITSI, but showed improvement over 10dB in some frequencies. There were no definite prognostic factors between the patients who responded to ITSI and those who didn't. CONCLUSION: ITSI is a simple and effective therapy for patients with refractory SSNHL.

A Case of Chondrosarcoma in Nasal Septum / 대한이비인후과학회지

Chondrosarcomas are malignant, slow-growing, cartilaginous tumors that are most commonly found in the pelvis, long bones and ribs, with approximately 5% to 10% located in head and neck. These tumors show diverse clinical features according to the morphologies, histological grades, and locations. Because most cases are characterized with nonspecific symptoms such as nasal obstruction and rhinorrhea, it can be misdiagnosed as rhinitis or sinusitis. For this reason, it if often detected when it has already reached locally advanced status. Chondrosarcomas in the head and neck region have a high local recurrence rate but rare distant metastases. The imaging study is essential and computed tomography shows calcified, low density mass occasionally with septal erosion. Magnetic resonance imaging shows low signal intensity in T1 weighted images, and high signal intensity in T2. Surgical resection is the definitive treatment of choice. Radiation and chemotherapy are reserved for residual disease and palliation. We present a case of the chondrosarcoma of nasal septum that was treated with craniofacial resection by craniotomy, and with bicoronal incision and midfacial degloving.

SPECT Assessment of Cerebral Perfusion in Head Injury

Patterns of abnormality in regional cerebral perfusion and its relation to clinical severity were evaluated with 29 brain injury patients with neurologic symptoms using 99mTc-HMPAO single photon emission tomography(SPECT). The findings were compared with computed tomography done within 48 hours of each SPECT study. The initial SPECT study was done within 3days of injury in 10 cases, between 4days and 3 weeks in 7 cases and after over 3 weeks in 12 cases. Nineteen patients underwent both SPECT and CT after a mean interval of 1 to 2 months. SPECT could detect abnormal perfusion in patients with nonspecific CT finding, and especially, SPECT was significant in chronic stage patients. SPECT detected more lesions than CT in size and number. There were a total of 54 supratentorial SPECT lesions in all. Ninity one percent(49/54) of these were of regional hypoperfusion, while 5 lesions(9%) showed focal hyperperfusion. The lesions were most often localized in the frontal and temporal lobes. Cerebellar diaschisis was observed in 55%(16/29) of patients, The degree of perfusion abnormality was quantified by product of differential percents activity and size factor. The degree of perfusion abnormality(SPECT grade) correlates well with clinical grade(P<0.01). And clinical improvement correlate well with follow up SPECT(P<0.05). Conclusively, SPECT can defect brain perfusion abnormality not found by CT. SPECT may be useful as a complementary study in the evaluation of head injury patient.

One Case of Traumatic Pericallosal Artery Aneurysm: A Case Report

Traumatic aneurysm is known to be very rare vascular disease. The authors experienced one case of traumatic aneurysm that occured on pericallosal artery after closed head injury. Traumatic aneurysm was suspected by enlarged traumatic ICH on the corpus callosum in brain CT scan and presence of signal voiding at the center of the hematoma in brain MRI scan and then confirmed by transfermoral carotid angiography. Clipped neck of this traumatic aneurysm successfully via interhemispheric approach, we report a case of traumatic pericallosal artery aneurysm with review of literatures.

Endotracheal Tube Obstruction due to Mucous Crust after General Anesthesia / 대한마취과학회지

A 4 year old girl was admitted for correction of PDA under the general anesthesia. A 4.5mm ID cuffed orotracheal Rusch tube was inserted and the Jackson-Rees system was used for maintenance of anesthesia with enflurane-nitrous oxide-oxygen. During surgery a mild increase in airway resistance was noticed and tachycardia was seen but all other vital signs were within normal limits. In the recovery room, she exhibited signs of complete airway oibstruction, and so the endotracheal tube was extubated. The obstruction was due to a dried mucous crust attached to the bevel of the endotracheal tube.

Endotracheal Tube Obstruction due to Mucous Crust after General Anesthesia / 대한마취과학회지

A 4 year old girl was admitted for correction of PDA under the general anesthesia. A 4.5mm ID cuffed orotracheal Rusch tube was inserted and the Jackson-Rees system was used for maintenance of anesthesia with enflurane-nitrous oxide-oxygen. During surgery a mild increase in airway resistance was noticed and tachycardia was seen but all other vital signs were within normal limits. In the recovery room, she exhibited signs of complete airway oibstruction, and so the endotracheal tube was extubated. The obstruction was due to a dried mucous crust attached to the bevel of the endotracheal tube.

Bronchial asthma, Atopic dermatitis, HLA type

We observed 285 cases of culture proved shigellosis from Jan. 1978 to July 1981 at W.M.B.H. in Busan. We specially observed the clinical and bacteriological response to Oxolinic acid in 59 cases from Jan. to July 1981. The following results were obtained. 1. The most commonly isolated shigella strains was Sh. flexneri (85.3%) followed by Sh. sonnei (7.4%), Sh. boydii (4.2%) and Sh. dysenteriae(3.2%). 2. Antibiotic sensitivity test revealed that more than 90% of strains were resistant to Tetracycline, Chloramphenicol and Ampicillin. Resistance strains to Gentamycin and Oxocid were found in less than 12.2% and 14.3% respectively. 3. The multiple antibiotic resistant strains were observed in about 80% of 59 strains, which were resistant to 3~5 antibiotics. The most of these strains were resistant to Ampicillin, Chloramphenicol and Tetracycline. In 3 cases it was resistant to all kinds of antibiotics but oxolinic acid. 4. Oxolinic acid showed growth-inhibitory zone of more than 11 mm with the concentration of 2mcg/ml in 95% and M.I.C. value of less than 0.76mcg/ml in 90%. 5. After administration of Oxolinic acid, there was clinical response within 2 days in 76.5% and conversion to negative stool culture within 2days in 68.8%. 6. Compared with placebo group, there was parallel clinical and bacteriologic effectiveness between Oxolinic acid and Rifampin.

Bronchial asthma, Atopic dermatitis, HLA type

We observed 285 cases of culture proved shigellosis from Jan. 1978 to July 1981 at W.M.B.H. in Busan. We specially observed the clinical and bacteriological response to Oxolinic acid in 59 cases from Jan. to July 1981. The following results were obtained. 1. The most commonly isolated shigella strains was Sh. flexneri (85.3%) followed by Sh. sonnei (7.4%), Sh. boydii (4.2%) and Sh. dysenteriae(3.2%). 2. Antibiotic sensitivity test revealed that more than 90% of strains were resistant to Tetracycline, Chloramphenicol and Ampicillin. Resistance strains to Gentamycin and Oxocid were found in less than 12.2% and 14.3% respectively. 3. The multiple antibiotic resistant strains were observed in about 80% of 59 strains, which were resistant to 3~5 antibiotics. The most of these strains were resistant to Ampicillin, Chloramphenicol and Tetracycline. In 3 cases it was resistant to all kinds of antibiotics but oxolinic acid. 4. Oxolinic acid showed growth-inhibitory zone of more than 11 mm with the concentration of 2mcg/ml in 95% and M.I.C. value of less than 0.76mcg/ml in 90%. 5. After administration of Oxolinic acid, there was clinical response within 2 days in 76.5% and conversion to negative stool culture within 2days in 68.8%. 6. Compared with placebo group, there was parallel clinical and bacteriologic effectiveness between Oxolinic acid and Rifampin.