A Comprehensive Review of the Acne Grading Scale in 2023.

Acne is a common skin inflammatory condition that can significantly affect the patient's quality of life. Therefore, accurate assessment scales are very important for treatment and management of acne vulgaris. This review article issues a comprehensive review of various acne severity assessment scales. In this text, the authors review the acne grading scales, such as the Pillsbury scale, Cook's acne grading scale, Leeds acne grading system, Global Acne Grading System, and investigator's global assessment, etc. And we delve into the characteristics, advantages, limitations, and applicability of these scales. The acne grading scale to be developed in the future should be objective, accurate, comprehensive, easy to use, and applicable in a variety of clinics and research settings. Current technologies, such as artificial intelligence, could potentially contribute to the development of ideal acne grading scales that meet unmet needs.

Colloidal InAs Quantum Dot-Based Infrared Optoelectronics Enabled by Universal Dual-Ligand Passivation.

Solution-processed low-bandgap semiconductors are crucial to next-generation infrared (IR) detection for various applications, such as autonomous driving, virtual reality, recognitions, and quantum communications. In particular, III-V group colloidal quantum dots (CQDs) are interesting as nontoxic bandgap-tunable materials and suitable for IR absorbers; however, the device performance is still lower than that of Pb-based devices. Herein, a universal surface-passivation method of InAs CQDs enabled by intermediate phase transfer (IPT), a preliminary process that exchanges native ligands with aromatic ligands on the CQD surface is presented. IPT yields highly stable CQD ink. In particular, desirable surface ligands with various reactivities can be obtained by dispersing them in green solvents. Furthermore, CQD near-infrared (NIR) photodetectors are demonstrated using solution processes. Careful surface ligand control via IPT is revealed that enables the modulation of surface-mediated photomultiplication, resulting in a notable gain control up to ≈10 with a fast rise/fall response time (≈12/36 ns). Considering the figure of merit (FOM), EQE versus response time (or -3 dB bandwidth), the optimal CQD photodiode yields one of the highest FOMs among all previously reported solution-processed nontoxic semiconductors comprising organics, perovskites, and CQDs in the NIR wavelength range.

The Usefulness of Multi Voice Evaluation for Measuring Voice Recovery After Endolaryngeal Phonomicrosurgery in Patients with Vocal Fold Polyps.

OBJECTIVES: The purpose of this study was to the usefulness of a five-variable model predicting perceived voice severity and incorporating acoustic analysis based on cepstral analysis and self-reported questionnaires, for measuring voice recovery after endolaryngeal phonomicrosurgery in patients with vocal fold polyps. METHODS: In this study, 72 patients with vocal fold polyps were included. Two voice evaluations, including acoustic analysis, self-reported questionnaires, and auditory perceptual assessments for each patient, were implemented before and after endolaryngeal phonomicrosurgery. Using these evaluations, we compared the mean values of the perceptual evaluation of voice, acoustic analysis parameters, self-reported questionnaires, and the five-variable model estimated severity pre- and post-endolaryngeal phonomicrosurgery. RESULTS: Various parameters related to acoustic analysis, self-reported questionnaires, and auditory perceptual assessments were useful for measuring voice recovery after endolaryngeal phonomicrosurgery. In particular, a five-variable model incorporating spectral/cepstral analyses and self-reported questionnaires was able to effectively track voice changes after endolaryngeal phonomicrosurgery. CONCLUSION: We verified that most of the variables and the five-variable model were useful for measuring voice recovery in patients with vocal polyps after endolaryngeal phonomicrosurgery.

Effect of Novel Polymer-Free Nitrogen-Doped Titanium Dioxide Film-Coated Coronary Stent Loaded With Mycophenolic Acid.

Background: Titanium is commonly used in blood-exposed medical devices because it has superior blood compatibility. Mycophenolic acid inhibits the proliferation of vascular smooth muscle cells. This study examined the effect of a non-polymer TiO2 thin film-coated stent with mycophenolic acid in a porcine coronary overstretch restenosis model. Methods: Thirty coronary arteries in 15 pigs were randomized into three groups in which the coronary arteries were treated with a TiO2 film-coated stent with mycophenolic acid (NTM, n = 10), everolimus-eluting stent with biodegradable polymer (EES, n = 10), or TiO2 film-coated stent (NT, n = 10). A histopathologic analysis was performed 28 days after the stenting. Results: There were no significant intergroup differences in injury score, internal elastic lamina area, or inflammation score. Percent area stenosis was significantly smaller in the NTM and EES groups than in the NT group (36.1 ± 13.63% vs. 31.6 ± 7.74% vs. 45.5 ± 18.96%, respectively, p = 0.0003). Fibrin score was greater in the EES group than in the NTM and NT groups [2.0 (range, 2.0-2.0) vs. 1.0 (range, 1.0-1.75) vs. 1.0 (range, 1.0-1.0), respectively, p < 0.0001]. The in-stent occlusion rate measured by micro-computed tomography demonstrated similar percent area stenosis rates on histology analysis (36.1 ± 15.10% in NTM vs. 31.6 ± 8.89% in EES vs. 45.5 ± 17.26% in NT, p < 0.05). Conclusion: The NTM more effectively reduced neointima proliferation than the NT. Moreover, the inhibitory effect of NTM on smooth muscle cell proliferation was not inferior to that of the polymer-based EES with lower fibrin deposition in this porcine coronary restenosis model.

Resonance Characteristics in Epiglottic Cyst: Formant Frequency, Vowel Space Area, Vowel Articulatory Index, and Formant Centralization Ratio.

OBJECTIVES: Resonance characteristics can change due to alterations in the shape of the vocal tract in patients with epiglottic cysts. This study aimed to analyze the resonance characteristics before and after the surgical excision of epiglottic cysts. METHODS: Twelve male patients with epiglottic cysts were enrolled in this study. We analyzed the first and second formants (F1 and F2) in vowels /a/, /e/, /i/, /o/, and /u/, vowel space area (VSA), vowel articulatory index (VAI), and formant centralization ratio (FCR). We measured these parameters before and after the surgical excision of epiglottic cysts. RESULTS: There was a significant increase in the F1 values of /a/, VSA, and VAI, and a significant decrease in the value of FCR after the surgery. CONCLUSION: We confirmed the change in the resonance characteristics in patients with epiglottic cysts. It is considered that further studies on epiglottic cysts and resonance changes are needed in the future.

Korean Voice Catastrophization Index (K-VCI): Validation of the Voice Catastrophization Index for Koreans.

OBJECTIVE: The purpose of present study was to validate a Korean version of the Voice Catastrophization Index for assessing catastrophization in patients with voice problems in a Korean population. METHODS: Case group patients with voice problems (n = 80) and control group patients without voice problems (n = 25) participated in the study. They were asked to complete three questionnaires: Korean Voice Handicap Index, Korean Voice-Related Quality of Life, and Korean Voice Catastrophization Index (K-VCI). Some of case group with voice problems completed the same three questionnaires again to assess test-retest reliability. Clinicians implemented the Consensus Auditory-Perceptual Evaluation of Voice evaluation to rate the overall severity on voice quality. RESULTS: K-VCI scores for case group were significantly higher than those for control group. K-VCI scores were significantly correlated with Korean Voice Handicap Index, Korean Voice-Related Quality of Life, and overall severity. The K-VCI had significant test-retest reliability and its internal consistency was good to excellent (range of Cronbach alpha correlation coefficients: 0.789-0.930). The K-VCI was not affected by patient sex, age, symptom duration, or diagnosis types. K-VCI scores were highest among patients with primary muscle tension dysphonia. CONCLUSION: We validated the K-VCI questionnaire for use in measuring the degree of catastrophization of voice problems in a Korean population. Future studies with a larger sample size will be necessary to further verify this and determine the clinical usefulness of the K-VCI.

Comparison of Cepstral Analysis Based on Voiced-Segment Extraction and Voice Tasks for Discriminating Dysphonic and Normophonic Korean Speakers.

OBJECTIVES: This study investigated whether there are differences in the discriminatory power of cepstral analysis according to the voiced-segment extraction method and voice tasks used for identifying dysphonic and normophonic Korean individuals. MATERIALS AND METHODS: A total of 2,863 subjects (2,595 subjects with and 268 subjects without dysphonia) were included in this study. The 3-second sustained vowel (SV) /a/ and one sentence of "Sanchaek" were edited and analyzed using Praat scripts. Cepstral analyses (cepstral peak prominence [CPP], smoothed cepstral peak prominence [CPPS], and low/high spectral ratio [LHRatio]) were performed using three voice tasks, namely, SV, continuous speech (CS), and extracted continuous speech (EXT) samples. Additionally, auditory-perceptual (A-P) assessments were performed by three speech language pathologists. RESULTS: Significant differences were found between dysphonic and normophonic voice groups for all cepstral parameters, except the LHRatio_EXT. Cepstral measurements of both SV and CS were highly correlated with A-P ratings. Furthermore, the diagnostic predictive power of CPP and CPPS for CS using the area under the receiver operating characteristic curve (AUC) was >0.919, the positive likelihood ratio (LR+) was ≥6.85, and the negative likelihood ratio (LR-) was ≤0.23. Additionally, for EXT, the AUC was >0.816, LR+ was 3.10, and LR- was ≤0.33. CONCLUSION: Both CS and EXT can predict dysphonia relatively well (r > 0.816). EXT showed lower predictability than the original sample (CS) analysis. Subsequent studies should implement voiced-segment extraction methods using various algorithms.

Mechanical and physio-biological properties of peptide-coated stent for re-endothelialization.

BACKGROUND: The aim of this study was to characterize the mechanical and physio-biological properties of peptide-coated stent (PCS) compared to commercialized drug-eluting stents (DESs). METHODS: WKYMVm (Trp-Lys-Tyr-Met-Val-D-Met), a stimulating peptide for homing endothelial colony-forming cell was specially synthesized and coated to bare metal stent (BMS) by dopamine-derived coordinated bond. Biological effects of PCS were investigated by endothelial cell proliferation assay and pre-clinical animal study. And mechanical properties were examined by various experiment. RESULTS: The peptide was well-coated to BMS and was maintained and delivered to 21 and 7 days in vitro and in vivo, respectively. Moreover, the proliferation of endothelial cell in PCS group was increased (approximately 36.4 ± 5.77%) in PCS group at 7 day of culture compare to BMS. Although, the radial force of PCS was moderated among study group. The flexibility of PCS was (0.49 ± 0.082 N) was greatest among study group. PCS did not show the outstanding performance in recoil and foreshortening test (3.1 ± 0.22% and 2.1 ± 0.06%, respectively), which was the reasonable result under the guide line of FDA (less than 7.0%). The nominal pressure (3.0 mm in a diameter) of PCS established by compliance analysis was 9 atm. The changing of PCS diameter by expansion was similar to other DESs, which is less than 10 atm of pressure for the nominal pressure. CONCLUSIONS: These results suggest that the PCS is not inferior to commercialized DES. In addition, since the PCS was fabricated as polymer-free process, secondary coating with polymer-based immunosuppressive drugs such as -limus derivatives may possible.

Two Cases of Aquagenic Wrinkling of the Palms in Korean Healthy Women: Easily Overlooked Disease.

Aquagenic wrinkling of the palms (AWP) is a rare condition, which is characterized by appearance of whitish papules and plaques and an excessive wrinkling and swelling of the palmar skin after exposure to water. Herein, we report two cases of AWP. A 17-year-old woman presented prickling focal various sized whitish papules, plaques with wrinkles on both palms after water contact for 6 months ago. Histologic findings were consistent with AWP. A 26-year-old woman presented asymptomatic multiple various sized whitish papules, plaques with wrinkles on both palms after water contact for 1 year ago. Both patients underwent a cystic fibrosis transmembrane conduct receptor test but were negative and improved without any treatment.

Comparison of Two Versions of the Acoustic Voice Quality Index for Quantification of Dysphonia Severity.

OBJECTIVES: The acoustic voice quality index (AVQI) is a specific acoustic indicator designed to objectively estimate dysphonia severity and measure the values of acoustic parameters based on the diagnostic category. This study compared the performance of two AVQI versions (2.02 and 3.01, v2 and v3) and PraatCPPS using a voice sample of Korean population. MATERIALS AND METHODS: Voice samples for sustained vowel and connected speech were elicited from 2257 patients across 14 diagnostic categories. Auditory-perceptual (A-P) assessments of dysphonia severity were compared to acoustic parameters of severity derived from two versions of the AVQI (v2 and v3) as well as the PraatCPPS. RESULTS: The AVQI-estimated severity (v2 and v3) and PraatCPPS severity for concatenated voice samples strongly correlated with each other and were significantly associated with A-P ratings. The AVQI (v2 and v3) and PraatCPPS showed high reliability in differentiating between pathological voice disorders. CONCLUSION: The AVQI (v2 and v3) and PraatCPPS were strongly correlated with the A-P ratings and provided valid estimates of dysphonia severity. However, the associations of the A-P ratings with the AVQIv2 were significantly stronger than those with the AVQIv3 and PraatCPPS, suggesting that the V2 outperformed the V3 and PraatCPPS.

Clinical Application of Two-Dimensional Scanning Digital Kymography in Discrimination of Diplophonia.

Purpose The purpose of this study was to investigate the characteristics of diplophonia using an auditory perception and multimodal simultaneous examination, which included sound waveform analysis, electroglottography (EGG), digital kymography (DKG), and 2-dimensional scanning digital kymography (2D DKG). Additionally, we compared the diagnostic accuracy of each method using a binary classifier in confusion matrix and convenience of discrimination, based on the time required for interpretation. Method One normophonic male, 12 patients with diplophonia, and 12 dysphonia patients without diplophonia were enrolled. A multimodal simultaneous evaluation was used to analyze the vibration pattern of diplophonia. Sensitivity, specificity, accuracy, area under the curve, and interpretation time were used to compare the various diagnostic methods. Discrimination was determined by 3 raters. Results There are 3 types of asymmetric vibratory patterns in diplophonia. The types are based on the oscillators vibrating at different frequencies: asymmetry of the left and right cords (6 subjects with unilateral palsy and 1 subject with vocal polyps), asymmetry of anterior and posterior cords (2 subjects with vocal polyps), and asymmetry of true and false cords (3 subjects with muscle tension dysphonia). All evaluation methods were useful as diagnostic tools, with all areas under the curve > .70. The diagnostic accuracy was highest with DKG (95.83%), followed by 2D DKG (83.33%), EGG (81.94%), auditory-perceptual evaluation (80.56%), and sound waveform (77.78%). The interpretation time was the shortest for auditory-perceptual evaluation (6.07 ± 1.34 s), followed by 2D DKG (10.04 ± 3.00 s), EGG (12.49 ± 2.76 s), and DKG (13.53 ± 2.60 s). Conclusions Auditory-perceptual judgment was the easiest and fastest method for experienced raters, but its diagnostic accuracy was lower than that of DKG or 2D DKG. The diagnostic accuracy of DKG was the highest, but 2D DKG allowed rapid interpretation and showed relatively high diagnostic accuracy, except in cases with space-occupying lesions. Supplemental Material https://doi.org/10.23641/asha.9911786.

Influence of Local Myocardial Infarction on Endothelial Function, Neointimal Progression, and Inflammation in Target and Non-Target Vascular Territories in a Porcine Model of Acute Myocardial Infarction.

BACKGROUND: Patients with acute myocardial infarction (AMI) have worse clinical outcomes than those with stable coronary artery disease despite revascularization. Non-culprit lesions of AMI also involve more adverse cardiovascular events. This study aimed to investigate the influence of AMI on endothelial function, neointimal progression, and inflammation in target and non-target vessels. METHODS: In castrated male pigs, AMI was induced by balloon occlusion and reperfusion into the left anterior descending artery (LAD). Everolimus-eluting stents (EES) were implanted in the LAD and left circumflex (LCX) artery 2 days after AMI induction. In the control group, EES were implanted in the LAD and LCX in a similar fashion without AMI induction. Endothelial function was assessed using acetylcholine infusion before enrollment, after the AMI or sham operation, and at 1 month follow-up. A histological examination was conducted 1 month after stenting. RESULTS: A total of 10 pigs implanted with 20 EES in the LAD and LCX were included. Significant paradoxical vasoconstriction was assessed after acetylcholine challenge in the AMI group compared with the control group. In the histologic analysis, the AMI group showed a larger neointimal area and larger area of stenosis than the control group after EES implantation. Peri-strut inflammation and fibrin formation were significant in the AMI group without differences in injury score. The non-target vessel of the AMI also showed similar findings to the target vessel compared with the control group. CONCLUSION: In the pig model, AMI events induced endothelial dysfunction, inflammation, and neointimal progression in the target and non-target vessels.

The Feasibility of a Prototype Thyroidoscope for Gasless Transoral Endoscopic Thyroidectomy: A Preclinical Cadaver Study.

Objective: This study aimed to evaluate the feasibility of the gasless transoral endoscopic thyroidectomy vestibular approach (TOETVA) using the Thyroidoscope, developed to maintain the surgical working space without CO2 insufflation. Materials and Methods: To prevent a potentially fatal CO2-related complication, we developed a retractable device, named the Thyroidoscope, which could maintain the surgical working space without CO2 insufflation. We conducted a preclinical cadaver study to evaluate its use in gasless TOETVA. Results: The Thyroidoscope provided a secure surgical field and stable image on the screen. We could successfully identify the recurrent laryngeal nerve, parathyroid gland, and other critical structures without inadvertent injury due to insertion of the Thyroidoscope. Conclusions: The Thyroidoscope provides sufficient working space to perform transoral thyroid surgery without the need for CO2 insufflation. Gasless TOETVA with the Thyroidoscope seems to be feasible and safe.

Efficacy of dextran and peptide-everolimus bi-directional stent.

Everolimus inhibits stent restenosis and the WKYMV (fluorescein isothiocyanate) peptide promotes endothelial homing. Dextran is a natural polymer that is widely used as a pharmaceutical agent. The purpose of this study was to develop a double-drug-coated stent using a bidirectional coating system and to examine the surface shape with in vitro experiments. Stent length was 16 mm and strut thickness was 70 µm (Chonnam National University Hospital Tiger stent). Optical and scanning electron microscopy showed good coating without cracks or bubbles. Fluorescein isothiocyanate-peptide was dip-coated on the lumen and the abluminal surface was coated with everolimus and dextran. Stents were coated with dextran, everolimus, or everolimus-dextran. The radial force and flexibility were measured to determine the mechanical properties. Contact angle testing was performed in all groups. Dextran and peptide as hydrophilic substances and everolimus as a hydrophobic substance were each coated on cover glasses (cobalt-chromium). A10 and human umbilical vein endothelial cells were used in the experiments. Water and dimethyl sulfoxide served as a control, and three drug groups were tested: peptide-everolimus, everolimus-dextran, and peptide-everolimus-dextran. Immunocytochemistry was performed to assess cell adhesion. Light intensity was plotted according to the average on nuclear staining. Experiments were conducted using 5-bromo-2'-deoxyuridine to investigate A10 and human umbilical vein endothelial cell proliferation. Cell adhesion and proliferation of peptide-everolimus-dextran were inhibited at A10, and human umbilical vein endothelial cell was found to proliferate with cell adhesion. On conclusion, dextran and peptide-everolimus bidirectional stent is effective in re-endothelialization and inhibition of cell proliferation.

Clinical Practicability of a Newly Developed Real-time Digital Kymographic System.

BACKGROUND: A digital kymogram shows real images of vocal fold vibration. However, DKG is difficult to use in clinical practice because the recorded image cannot be seen instantaneously after examination, as considerable encoding time is required to visualize a digital kymogram. In addition, frame-by frame analysis should be implemented to evaluate high-speed videoendoscopy data, but is time- and labor-intensive. PURPOSE: The purpose of the study was to validate the clinical practicability of a real-time multislice digital kymographic system developed by the authors. We analyzed the promptness and accuracy of the examination before and after intracordal injections in patients with unilateral vocal fold paralysis. METHODS: To assess the clinical applicability of this system, six patients with unilateral vocal fold paralysis were selected. Real-time DKG was performed before and immediately after intracordal injection. We observed changes in the digital kymogram after the intracordal injection. RESULTS: Using this system, 10 scanning lines and up to five vertical pixel row could be obtained in real time, and the maximum acquisition time for the DKG image was 10 seconds. A digital kymogram of the patients could be instantaneously acquired, and whether the intracordal injection was appropriate or not. CONCLUSION: This article is the first validation study after the development of the real-time multislice digital kymographic system. Our system may be a promising tool in clinical practice for immediate assessment of the vibratory patterns of the vocal cords. More research is necessary for further clinical validation.

Efficacy of Two-dimensional Scanning Digital Kymography in Evaluation of Atrophic Vocal Folds.

OBJECTIVE: The purpose of this study was to evaluate the clinical feasibility and diagnostic accuracy of two-dimensional scanning digital kymography (2D DKG) in patients with vocal cord atrophy before and after treatment. MATERIALS AND METHODS: We analyzed the characteristics of vocal fold vibration in five patients with unilateral vocal fold paralysis and five patients with presbyphonia. In patients with vocal cord paralysis, the status before and after intracordal injection was compared. Furthermore, in patients with presbyphonia, we compared the status before and after voice therapy (Seong-Tae Kim's laryngeal calibration technique). Quantitative parameters such as amplitude and phase symmetry indices, jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time and qualitative parameters such as Voice Handicap Index, glottal gap, amplitude, and phase difference were used to evaluate the pre- and post-treatment status. RESULTS: In cases of vocal cord paralysis, vibratory changes of the vocal folds before and after intracordal injection could be identified immediately using 2D DKG. In overcorrection cases, all of the measured parameters were poor except for improvement of the glottal gap. In addition, 2D DKG showed appropriately the changes in vocal cord vibration before and after voice therapy in patients with presbyphonia. CONCLUSION: Two-dimensional DKG may be a useful diagnostic tool in evaluation of the vibratory characteristics of entire vocal cords. In addition, it may also play a role in providing a decision for treatment modalities.

Usefulness of Two-Dimensional Digital Kymography in Patients With Vocal Fold Scarring.

OBJECTIVE: Although laryngeal videostroboscopy is widely utilized in the analysis of vocal fold vibrations, it is often difficult to identify patterns of vocal fold vibrations in patients with aperiodic voice signals due to failure of synchronization during laryngeal videostroboscopy examination. Therefore, the present study aimed to compare the usefulness of simultaneous two-dimensional digital kymography (2D DKG) and traditional DKG for the detection of changes in the pattern of vocal fold vibrations in patients with vocal fold scarring (VFS). METHODS: Seven patients with VFS and one normal subject underwent high-speed videoendoscopy (HSV). DKG and 2D DKG evaluations of vocal fold vibrations were performed simultaneously, following which both qualitative and quantitative analyses were performed. RESULTS: Simultaneous DKG and 2D DKG enabled observation of vibratory patterns as well as amplitude and phase symmetry. DKG revealed and provided temporal information regarding the pattern of vocal fold vibrations at sites of VFS. In contrast, 2D DKG provided real-time information regarding the pattern of vibrations for the whole vocal fold region and regions of increased stiffness, as well as spatial information regarding changes in this pattern. CONCLUSION: Our findings indicate that 2D DKG enables the assessment of overall vocal fold vibrations, regardless of periodicity, and that simultaneous DKG and 2D DKG can be used to confirm abnormal patterns of vocal fold vibrations in patients with impaired flexibility and elasticity of the vocal folds.

Validation of the Acoustic Voice Quality Index in the Korean Language.

OBJECTIVE: The purpose of this study was to explore the concurrent validity of the Acoustic Voice Quality Index (AVQI) in a Korean population. We investigated the feasibility of its cutoff values and diagnostic accuracy in discriminating between normal and dysphonic voices. MATERIALS AND METHODS: A total of 1,524 native Korean subjects with normal voices (n = 113) and with voice disorders (n = 1,411) were asked to speak and sustain the vowel "a" and to read the Korean text "Walk" aloud. A 2-second mid-speech portion of the sustained vowel sound and two sentences (with 26 syllables) were edited and concatenated, and the AVQI was calculated. Additionally, two auditory-perceptual assessments, namely the Grade, Roughness, Breathiness, Asthenia, Strain scale, and the Consensus Auditory-Perceptual Evaluation of Voice were used by five speech language pathologists to rate the severity of dysphonia. RESULTS: Both auditory-perceptual assessments showed high confidence levels among the five speech language pathologists. The AVQI correlated with grade (G) and overall severity (OS). There were statistically significant differences in AVQI, G, and OS between normal and pathological speech groups. In the receiver operating characteristic curve analysis, AVQI, G, and OS cutoff values were <3.33, <0.00, and <22.00, respectively. The receiver operating characteristic curve analysis indicated that AVQI had excellent diagnostic accuracy for discriminating between normal and dysphonic voices (area under the curve: 0.970-0.977). CONCLUSIONS: We demonstrated the concurrent validity of AVQI as a promising tool for assessing overall voice quality and quantifying dysphonia in a Korean-speaking population.

Effects of Injection Laryngoplasty with Hyaluronic Acid in Patients with Vocal Fold Paralysis.

OBJECTIVES: The purpose of this study was to explore the effects of injection laryngoplasty (IL) with hyaluronic acid in patients with vocal fold paralysis (VFP). METHODS: A total of 50 patients with VFP participated in this study. Pre- and post-IL assessments were performed, which included analyzing the sustained vowel /a/ phonation, and the patient reading 1 Korean sentence from the "Walk" passage that comprised 25 syllables in 10 words. To investigate the effect of IL on vocal fold function, acoustic analysis (acoustic voice quality index, cepstral peak prominence, maximum phonation time, speaking fundamental frequency) was conducted and auditory-perceptual (grade and overall severity), visual judgment (gap), and self-questionnaire (voice handicap index-10) assessments were performed. RESULTS: The patients with VFP showed statistically significant differences between pre-and post-IL assessments for acoustic and auditory-perception, visual judgment, and self-questionnaire assessments. CONCLUSION: The patients with VFP showed positive change in vocal fold function between pre- and post-IL measurements. The findings showed that IL with hyaluronic acid is an effective method to improve vocal fold function in patients with VFP.

In vitro and in vivo evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition.

Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO2) and verify its efficacy by in vitro and in vivo assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO2 stent, everolimus-eluting N-TiO2 (N-TiO2-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO2 film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO2 deposition (37.0%). The platelet adhesion on the N-TiO2 surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO2-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO2-EVL group compared to that in the BMS group. The results (BMS; 47.0 ±â€¯11.00%, N-TiO2-EVL; 31.7 ±â€¯10.50%, and EES; 29.1 ±â€¯11.21%, n = 10, p < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO2 deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.