Facile one-pot synthesis of biomass-derived activated carbon as an interlayer material for a BAC/PE/Al2O3 dual coated separator in Li-S batteries.

Lithium-sulfur batteries (LSB) are an attractive alternative electrochemical energy storage device compared to conventional lithium-ion batteries due to their higher theoretical capacity and energy density. Despite these advantages, it is still difficult to commercialize LSB because of poor electrochemical performance caused by the dissolution of soluble lithium polysulfides (LiPS). To solve these critical issues, a multi-functional separator was prepared using biomass-derived activated carbon (BAC) and a ceramic layer on the polyethylene (PE) separator. For this purpose, BAC was synthesized by a facile one-pot synthesis method by a specifically designed furnace using various forms of milk waste. The multi-functional separator suppresses the effect of LiPS dissolution and increases the Li+ diffusion kinetics. BAC was able to absorb the LiPS shuttle, as confirmed by UV-vis measurements and X-ray photoelectron spectroscopy (XPS). LSB cells assembled using this multi-functional separator show a higher discharge capacity of 1092.5 mA h g-1 at 0.1 C-rate, while commercial PE separators deliver a specific capacity of 811.8 mA h g-1. These novel separators were also able to suppress lithium dendrites during cycling. This work offers a novel and simple approach for streamlining the synthesis process of BAC and applying it to LSB, aiding in the development of sustainable energy sources.

Treatment Efficacy of Various Maneuvers for Lateral Canal Benign Paroxysmal Positional Vertigo With Apogeotropic Nystagmus: A Randomized Controlled Trial.

OBJECTIVES: The aim of this study was to determine the most effective treatment approach by comparing the impacts of various otolith reduction techniques in patients with apogeotropic lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV). METHODS: We performed a multicenter randomized prospective study from January to December 2015, involving 72 consecutive patients with apogeotropic LC-BPPV. The patients were divided into three treatment groups: therapeutic head-shaking (group A), the Gufoni-Appiani maneuver (group B), and the cupulolith repositioning maneuver (CuRM; group C). Each group underwent evaluation and treatment up to the fourth week. Treatment success was defined as the disappearance of positional vertigo and nystagmus. RESULTS: This study included 72 patients (49 male and 23 female), with a mean (±standard deviation) age of 55.4±13.5 years. The mean duration of vertigo experienced prior to treatment was 3.9±4.4 days. The mean latency and duration of nystagmus were 2.7±3.0 seconds and 47.9±15.8 seconds, respectively. The overall treatment frequency was 2.0±0.9. The number of treatments differed significantly among the three groups (P<0.05). After 4 weeks, the success rates for groups A, B, and C were 90.5%, 92.3%, and 100%, respectively. No significant difference was observed in the success rate across treatment. METHODS: and periods (P>0.05). However, CuRM was the only method with a 100% treatment success rate. CONCLUSION: While no clear difference was observed among the three treatments for LC-BPPV, CuRM was found to be superior to the other approaches in the long term.

Application of electrodeposited Cu-metal nanoflake structures as 3D current collector in lithium-metal batteries.

Since uncontrolled lithium (Li) dendrite growth and dendrite-induced dead Li severely limit the development of Li metal batteries, 3D Cu current collectors can effectively alleviate these problems during Li plating/stripping. Herein, one-step galvanostatic electrodeposition method is employed to fabricate a new current collector on Cu foam decorated with large-scale and uniform 3D porous Cu-based nanoflake (NF) structures (abbreviated as 3D Cu NF@Cu foam). This 3D structure with large internal surface areas not only generates lithophilic surface copper oxides and hydroxides as charge centers and nucleation sites for Li insertion/extraction, but also endows abundant space with interlinked NFs for buffering the cell volume expansion and increasing battery performance. As a result, Li-deposited 3D Cu NF@Cu foam current collector can realize stable cycling over 455 cycles with an average Coulombic efficiency of 98.8% at a current density of 1.0 mA cm-2, as well as a prolonged lifespan of >380 cycles in symmetrical cell without short-circuit, which are superior to those of blank Cu foam current collector. This work realizes Li metal anode stabilization by constructing 3D porous Cu NFs current collectors, which can advance the development of Li metal anode for battery industries.

Idiopathic benign paroxysmal positional vertigo in the elderly: a long-term follow-up study.

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral-type vertigo in the elderly. While some studies have investigated BPPV among the elderly, no study has focused on the isolated idiopathic BPPV (iBPPV) in the elderly. AIMS: To investigate the clinical features and recurrence rate in elderly patients diagnosed with iBPPV. METHODS: The authors prospectively reviewed the medical records of 627 patients diagnosed with BPPV, and a total of 370 patients fulfilled the inclusion criteria. The subjects were divided into two groups by age (experimental group ≥65 years and control group 17-64 years), and the gender, numbers of canalith reposition maneuver (CRM) for successful treatment, time elapsed from onset of symptoms to clinic visit, the affected semicircular canal, and the 1- and 5-year recurrence proportion were analyzed. RESULTS: The gender, numbers of CRM for successful treatment, affected semicircular canal, and the 1- and 5-year recurrence proportion showed no statistically significant difference between two groups (p > 0.05). The only exception was the experimental group which took a longer duration from manifestation of symptoms to hospital visit than control group (student's t test, p = 0.021). DISCUSSION: Several previous studies report that the elderly with iBPPV shows more protracted clinical course and much higher recurrence rate than younger adult. Unlike those reports, our study showed no significant differences about the clinical features and recurrence rate between age groups. CONCLUSION: The elderly with iBPPV could be treated as effective as general population.

Comparison of clinical features and EBV expression in histiocytic necrotizing lymphadenitis of children and adults.

OBJECTIVE: Histiocytic necrotizing lymphadenitis (HNL) is a self-limiting disease characterized by cervical lymphadenopathy and fever. Epstein-Barr virus (EBV) has been implicated as a cause of HNL in some reports but not in others. The aim of this study was to compare the clinical features and laboratory findings in children and adults with HNL and to evaluate the relationship between EBV infection and HNL. METHODS: The records of patients diagnosed with biopsy-confirmed HNL at Gyeongsang National University Hospital from May 2009 to December 2012 were retrospectively reviewed. Clinical features, laboratory data (blood count, biochemistry, and serology), and computed tomography findings were collected. Immunohistochemistry for CD4, CD8, CD68, and myeloperoxidase (MPO), and in situ hybridization for EBV RNA were performed on archived lymph node biopsies from pediatric and adult patients. RESULTS: A total of 16 children and 31 adults were diagnosed with HNL. Fever was present in 87.5% of children and 25.8% of adults (P<0.0001). Fever duration was longer for children (mean, 5.06 days) than for adults (mean, 0.63 days; P=0.008). Necrosis of the involved lymph nodes was observed in eight (50%) children and six (19.4%) adults (P=0.045). HNL recurred in five (31.35%) children and one (3.2%) adult (P=0.015). All had detectable CD4, CD8, CD68, and MPO immunoreactivity. EBV reactivity was higher in children (26.7%) than in adults (6.7%) without statistical support. CONCLUSIONS: There is more variability in the clinical presentation and laboratory findings in children with HNL than in adults. In particular, the degree and duration of fever was more severe in children than in adults, and necrosis of lymph nodes was more frequent in children than in adults. There was no definitive correlation between EBV reactivity and NHL. Further study of the relationship between EBV and HNL is needed with a larger number of patients.

Ethmoidal mucocele presenting as oculomotor nerve paralysis.

A 56-year-old male was admitted with an acute headache and sudden ptosis on the right side. No ophthalmological or neurological etiologies were apparent. A mucocele of the right posterior ethmoid sinus was observed with radiology. After the marsupialization of the mucocele via a transnasal endoscopic approach, the patient's symptoms (oculomotor nerve paralysis and headache) resolved in 4 weeks. Oculomotor paralysis is a rare symptom of an ethmoidal mucocele. In this article, we report this rare case along with a literature review.

Effect of high dose intravenous vitamin C on idiopathic sudden sensorineural hearing loss: a prospective single-blind randomized controlled trial.

The aim of this prospective single-blind randomized controlled study was to evaluate the therapeutic efficacy of high dose intravenous vitamin C (HDVC) added to systemic steroid in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Between August 2010 and August 2011, 72 ISSNHL patients who participated in this study were randomly allocated to two groups: 36 to a control group, members of which were given systemic steroid treatment for 15 days, and 36 to a HDVC group, members of which were given HDVC (200 mg/kg/day) for 10 days in addition to steroid therapy followed by oral vitamin C (2,000 mg) for 30 days after discharge. Finally, we analyzed each group: 35 as a control group and 32 as a HDVC group. Auditory evaluations were performed by pure tone audiometry (PTA) before and ~1 month after treatment using Siegel's criteria. HDVC group showed significantly greater complete and partial recovery improvement (p = 0.035). In addition, the complete recovery rate in the HDVC group was more than twice that of the control group (p = 0.031). In the HDVC group, PTA improved from 67.6 ± 19.8 dB HL before treatment to 37.1 ± 28.8 dB HL at 1 month after treatment, whereas in the control group, PTA improved from 70.3 ± 12.4 to 47.6 ± 25.2 dB HL, which represented a significant intergroup difference (p = 0.030). In conclusion, HDVC may enhance hearing recovery in ISSNHL patients, which suggests that HDVC reduces levels of reactive oxygen metabolites produced by inner ear ischemia or inflammation, and that HDVC could be considered for the treatment of ISSNHL.

Roles of periostin in symptom manifestation and airway remodeling in a murine model of allergic rhinitis.

PURPOSE: Periostin was originally identified as a secreted factor during screening of a mouse osteoblastic library. In a recent study, periostin was found to directly regulate eosinophil accumulation in allergic mucosal inflammation. Chronic eosinophilic inflammation is related to the development of remodeling. The present study examined the expression of periostin and evaluated its role in the inflammatory process and remodeling associated with allergic rhinitis. METHODS: A murine model of allergic rhinitis was established in periostin knockout mice. We analyzed the expression of periostin, manifestation of nasal symptoms, eosinophilic inflammation, and subepithelial fibrosis as well as the expression of MMP-2, TIMP-1, and type 1 collagen in nasal tissue. RESULTS: Periostin was mainly distributed in the subepithelial tissue of the nasal mucosa. The subepithelial tissue was thinner in the knockout group than in the control group. No differences in the expression of MMP-2 or TIMP-1 were found in the knockout group. However, after a month of allergen challenge, type I collagen in the nasal tissue was lower in the knockout group than in the control group. The number of eosinophils and the symptom score were also lower in the knockout group. CONCLUSIONS: Periostin is expressed in nasal tissues of murine models of allergic rhinitis. Periostin deficiency may affect the remodeling of nasal tissue with reduced subepithelial fibrosis, and lead to less eosinophilic inflammation.

Clinical characteristics and natural course of recurrent vestibulopathy: a long-term follow-up study.

OBJECTIVES/HYPOTHESIS: To investigate the clinical characteristics and the natural course of recurrent vestibulopathy (RV). STUDY DESIGN: Retrospective study. METHODS: During the period April 2002 to February 2008, we reviewed the clinical records of 98 patients diagnosed with RV. All patients were approached by telephone and using a questionnaire. The analysis included age, sex distribution, natural history, pure-tone audiometry, caloric response, age at onset, and the characteristics of vertigo. RESULTS: Median follow-up was 63.1 months (range, 24-103 months). Patients had a mean age at onset of 39 years and a mean duration of 4.2 years. An obvious female predilection was found, and unilateral caloric paresis (≥ 25%) was seen in 35%. Of the 98 patients, symptoms resolved in 82% but were unchanged in 12%. RV developed to Ménière's disease in four patients and to migraine in two. No patient with RV developed a central nervous system disease or benign paroxysmal positional vertigo during follow-up. CONCLUSIONS: The study suggests that in the majority of cases, vertigo spontaneously resolves and that the risks of development to Ménière's disease or migraine are low.

Clinical significance of the presence of autonomic and vestibular dysfunction in diabetic patients with peripheral neuropathy.

BACKGROUND: We investigated the prevalence of diabetic autonomic neuropathy (DAN) and vestibular dysfunction (VD) in diabetic patients with peripheral neuropathy. METHODS: Thirty-five diabetic patients with peripheral neuropathy were enrolled from August 2008 to July 2009. All subjects underwent autonomic function tests. Nineteen of the patients (54.3%) underwent videonystagmography. RESULTS: Diabetic autonomic neuropathy was observed in 28 patients (80%). A mild degree of autonomic failure was observed in 18 patients (64.3%), and a moderate degree of autonomic failure was observed in ten patients (35.7%). Factors related to DAN included diabetic nephropathy (P=0.032), degree of chronic kidney disease (P=0.003), and duration of diabetes (P=0.044). Vestibular dysfunction was observed in 11 of 19 patients (57.9%). There was no significant association between DAN and VD. CONCLUSION: Diabetic autonomic neuropathy was observed in 28 diabetic patients (80%) with peripheral neuropathy. Vestibular dysfunction was observed in nearly 60% of diabetic patients with peripheral neuropathy who complained of dizziness but showed no significant association with DAN. Diabetic patients who complained of dizziness need to examine both autonomic function and vestibular function.

Endoscope-assisted intraoral resection of external dermoid cyst.

BACKGROUND: Surgical removal of a dermoid cyst is usually accomplished through an external neck incision. However, this procedure inevitably results in a neck scar. METHODS: We report the case of a 17-year-old woman with a submental mass. We implemented a modified approach to dermoid cyst removal through the floor of the mouth using an endoscope system. RESULTS: The patient received a modified approach to dermoid cyst removal and remains free of disease 6 months after excision. CONCLUSION: Resection of the submental type dermoid cyst can be performed by an intraoral endoscope-assisted approach through the floor of the mouth. We describe the procedure of the endoscope-assisted intraoral resection.

Sensation recovery of auricle following chronic ear surgery by retroauricular incision.

The aim of this prospective analysis was to objectify and quantify the sensory loss in the auricular area that occurs following surgery for chronic otitis media or cholesteatoma, and to assess the exact recovery time of the auricular sensation. Till now, no study has yet been conducted on the sensory loss that is developed after retroauricular incision is performed for chronic ear surgery. Forty-eight patients underwent surgery via retroauricular incision for chronic otitis media or for chronic otitis media or cholesteatoma between March 2009 and January 2010. The skin around the auricle was divided into six areas. The sensation of each area was assessed before the surgery and 3 days, 7 days, 1 month, 3 months, and 6 months after the surgery, using the Semmes-Weinstein monofilaments. The patients were also asked to record the sensation that they felt using the visual analog scale (VAS). In the objective sensory assessment, only area 5, which corresponds to the retroauricular area, showed significant sensory loss. Three months after the surgery, the sensation was recovered to a level comparable to that before the surgery in most of the patients. The mean subjective VAS score was 10 prior to the surgery, 8.56 (± 1.08) 3 months after the surgery, and 9.32 (± 0.74) 6 months after the surgery, respectively. In conclusion, following chronic ear surgery, the sensation of the auricle was recovered to the previous level within 3 months. Therefore, patients who are to undergo retroauricular incision should be informed that they will experience temporary sensory loss for approximately 3 months after the surgery.

Immunohistochemical and biomolecular identification of melatonin 1a and 1b receptors in rat vestibular nuclei.

OBJECTIVE: The aim of this study was to examine the localizations and expressions of melatonin 1a (MT1a) and 1b (MT1b) receptors in rat vestibular nuclei by immunohistochemical staining and reverse transcriptase-polymerase chain reaction. MATERIALS AND METHODS: Twenty male Sprague-Dawley rats were used in this study. Antibodies for the MT1a and MT1b receptors were used in 10 rats, respectively. A further 10 animals were sacrificed for RT-PCR. Tissues containing medial vestibular nuclei were selectively isolated from brain stem slices for RT-PCR. RESULTS: MT1a and MT1b receptor immunopositive neurons were found to be distributed throughout the four major vestibular nuclei. Both receptors were primarily detected in neuronal somata and their proximal dendrites. The presences of the mRNAs of the MT1a and MT1b receptors were confirmed by RT-PCR in medial vestibular nuclei and trigeminal ganglia. CONCLUSIONS: The present study demonstrates, for the first time, that MT1a and MT1b receptors are localized and expressed in rat vestibular nuclei. This study provides additional insight into the role of melatonin receptors during vestibular signal processing.

Clinical characteristics and treatment of benign paroxysmal positional vertigo after traumatic brain injury.

BACKGROUND: Traumatic brain injury (TBI) has been reported to be a common cause of benign paroxysmal positional vertigo (BPPV). However, only a few studies have investigated BPPV after TBI. The aim of this study was to identify the clinical characteristics of BPPV after TBI and to determine whether there are clinical differences between BPPV after TBI and idiopathic BPPV. METHODS: The authors reviewed the medical records of 192 consecutive patients with positional vertigo after head injury during the period 2003 to 2009 and investigated 112 patients with idiopathic BPPV treated over the same period. The clinical characteristics of BPPV after TBI and the clinical differences between the traumatic BPPV and idiopathic BPPV groups were investigated. RESULTS: A total of 32 patients with BPPV after TBI fulfilled the inclusion criteria. Twenty-four patients in the traumatic BPPV group had posterior semicircular canal-BPPV and 11 patients lateral semicircular canal-BPPV. A total of 58 repositioning maneuver sessions were performed in these 32 patients. Members of the traumatic BPPV group required more treatment sessions than members of the idiopathic group (p<0.05), but no tendency to recur was observed in the traumatic group (p>0.05). Recurrence rates in the traumatic and idiopathic BPPV groups were 15.6% and 18.8%, respectively (p>0.05). CONCLUSIONS: It is likely that BPPV after TBI is more difficult to treat than idiopathic BPPV, but no tendency to recur was observed in patients who developed BPPV after TBI compared with idiopathic BPPV. Further prospective clinical meta-analytic studies are needed to investigate the outcome of BPPV after TBI.

Distribution of 5-HT1B and 5-HT1D receptors in the inner ear.

Migraine and anxiety disorders are frequently co-morbid with balance disorders. This study examined the relative distribution of subtypes of serotonin (5-HT) receptor in the inner ear of monkeys and rats. Most vestibular ganglion cells were immunoreactive for 5-HT(1B) and 5-HT(1D) receptors in macaques and rats. In the inner ear, 5-HT(1B) and 5-HT(1D) receptor immunopositivity was associated with endothelial cells of the vestibular ganglion, spiral ganglion, vestibulocochlear nerve, spiral ligament and stria vascularis. It was noteworthy that 5-HT(1B) and 5-HT(1D) receptors are expressed in parallel sites in peripheral vestibular and trigeminal systems, which may be a factor underlying the efficacy of triptans in treating migraine and migrainous vertigo. Because the vestibular ganglion and trigeminal ganglion are both within the subarachnoid space, an interaction between 5-HT(1B) and TRPV1 receptors on blood vessel and ganglion cells may also contribute to the vasospasm and the comorbid headache, dizziness, nausea and vomiting that accompany subarachnoid hemorrhage.

A rare case of pontomedullary infarction presenting with peripheral-type facial palsy.

Ipsilateral facial palsy (FP) of the peripheral-type can result from lesions involving the inferomedial tegmentum of the pons. However, cases of a medullary lesion with peripheral-type FP have rarely been reported. The authors experienced an 83-year-old man with a pontomedullary infarction who presented with ipsilateral peripheral-type FP. Brain diffusion MRI revealed a hyper-intense signal on the left dorsolateral portion of the upper medulla and pontomedullary junction. This case suggests that clinicians should take into account the possibility of a central lesion and brainstem infarction, even when patients present with peripheral-type FP.

Immunohistochemical and biomolecular identification of 5-HT7 receptor in rat vestibular nuclei.

The association between migraine and balance disorder morbidities has been a topic of interest for many years, and serotonin (5-HT) receptor is known to be closely related with migraine and also to be associated with vestibular symptoms. However, the mechanism underlying the pathogenesis of migrainous vertigo and its association with 5-HT has not been elucidated. Of the many 5-HT receptors, 5-HT7 receptor has recently attracted attention in the context of migraine treatment. The purpose of this study was to investigate the localization and expression of 5-HT7 receptor in the rat vestibular nuclei by immunohistochemical staining and reverse transcriptase-polymerase chain reaction (RT-PCR). The present study might provide additional insight into the role of 5-HT7 receptor in the pathogenesis of migraine-related vestibular symptoms.

Surgical management of intraoral ranulas in children: an analysis of 17 pediatric cases.

OBJECTIVE: The preferred treatment of pediatric intraoral ranulas remains controversial. We present our experience with ranulas at the Gyeongsang National University Hospital and review the literature. METHODS: The study involved 17 children under 15 years of age who visited our hospital from 2001 to 2008 and were diagnosed with a ranula exceeding 2 cm in diameter. The age and gender of the patients, the surgical procedures, presurgical observation period, postsurgical follow-up period, and complications of each case were determined. The unruptured specimens were all subjected to detailed pathological analysis. RESULTS: The patients were on average 9.3 years and there were 10 girls and 7 boys. Spontaneous resolution was not detected in any of the cases during the presurgical observation period. Indeed, in two cases, the ranula had increased in size. The ranula and sublingual gland (SG) were resected in all cases. The average operation time was 1h. Recurrence and complications were not detected in any of the cases. Pathological analyses revealed that there was no communication of the ranula with the SG in any of the cases. CONCLUSIONS: Our experiences suggest that the presurgical observation period need not be longer than 3 months and that the resection of ranulas along with the ipsilateral SG is a safe and effective primary treatment for symptomatic pediatric intraoral ranulas that exceed 2cm in diameter.

Wound healing of nasal mucosa in a rat.

BACKGROUND: Postoperative wound healing of the nasal mucosa is a highly organized process. However, this process still has not been fully understood. The present study aimed to establish a wound healing model in a rat and describe histomorphological changes of the nasal mucosa after mechanical injury. METHODS: Unilateral wound in the nasal cavity was induced using the brushing technique in 4-week-old, Sprague-Dawley rats. Experimental rats were divided into five groups (n = 7 for each group). Animals were killed 1 hour and 2, 5, 14, and 28 days after injury. The histological sections were examined for inflammatory cell infiltration, goblet, and ciliated cell formation in hematoxylin and eosin staining. The subepithelial and epithelial thicknesses were measured and expressed as the subepithelial thickness index (STI) and epithelial thickness index (ETI). Fibrosis was evaluated by subepithelial fibrosis index (SFI) in Masson's trichrome-stained sections. RESULTS: Respiratory epithelial discontinuity and hemorrhage were observed 1 hour after injury. On day 2, edematous subepithelium and infiltration of neutrophils could be found on the injured site. Day 5 was characterized by the infiltration of monocytes and granulation tissue. SFI and ETI values increased significantly at day 14. Goblet cells and ciliated cells began to regenerate from day 14 and restored to near normal at day 28. CONCLUSION: Using mechanical injury, the wound healing model of the nasal mucosa was established in a rat. The regeneration of respiratory mucosa was completed on day 28 after injury.