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        Audiologic Results of Ossiculoplasty Using Malleus Footplate Assembly: The Comparison between Autologous Incus and Hydroxyapatite

        Sun O Chang,Sue Jean Mun,Joo Hyun Park,Chang Myeon Song,Kyu-Hee Han,이준호,Seung Ha Oh 대한청각학회 2011 Journal of Audiology & Otology Vol.15 No.3

        Introduction A disruption of the ossicular chain of the middle ear causes conductive hearing loss. Ossicular reconstruction is performed to restore hearings in those patients with congenital ossicular chain anomaly or ossicular chain disruption caused by chronic otitis media or cholesteatoma. A study from Japan with 52 auditory ossicular malformation revealed that 44% of the patients had a fixation of the stapes, 40% had incudostapedial joint defects followed by fixation of the malleus and/or incus and defects in the incudostapedial joint with a fixation of the stapes.1) One of the most common ossicular chain anomalies in Korea was a stapes footplate fixation (54.5%) followed by a mobile stapes footplate with other anomalies (19.7%) including a stapes without suprastructure and an incus long process, stapes without anterior crus and an incus long process.2) One of the most common ossicular chain anomalies is the absence of an incus with or without an intact stapes suprastructure. In incudostapedial deformed ears, ossiculoplasty is mandatory to restore the hearing process. Ossiculoplasty is also needed in cases with incus long process erosion with inflammation. As the most vulnerable ossicles, one report said that incus erosion is found in 80% of the chronic otitis media.3) Austin-Kartush classified ossicular chain disruptions into four categories after 1,151 operation on chronic otitis media. Group A ears with an intact malleus handle and a stapes suprastructure was found in 59.2% followed by group B ears with an intact malleus handle but an eroded stapes suprastructure group.4) In the group of a tympanic membrane and malleus preserved but a stapes suprastructure eroded, ossicular continuity can be restored between the stapes footplate and manubrium of the malleus with the method of malleus footplate assembly (MFA) using either the incus body or if the incus is unavailable, a biocompatible material such as hydroxyapatite (HA).5,6,7) Until now, MFA has proven to be the safe and effective way to restore hearings in such patients.8,9,10,11,12)Though successful results using MFA with either incus body or biocompatible material are reported world widely, there were a few reports on audiologic results after MFA ossiculoplasty in Korea. Authors reviewed our procedure and report hearing results of ossiculoplasty with MFA using either incus or HA. In this paper, a single-surgeon series of 32 MFA operations was analyzed. The cases were limited to autologous interposition grafts performed on Austin-Kartush group B ears in order to provide consistency within the analysis. Subjects and Methods Data collection A retrospective evaluation has been carried out on patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in Seoul National University Hospital. A total of 55 patients with Austin-Kartush type B defect repaired with incus body or HA were identified. Of those, 20 were excluded due to a failure to recover operation records or a lack of no more than 1 year postoperative audiograms. Three patients who had undergone MFA with a homologous incus were excluded in order to provide consistency within the analysis. Finally, 32 cases were enrolled into the study. All procedures were conducted by a single surgeon. All data including previous operations, follow-up duration, age, sex, etiology, materials which were used in the operation, combined mastoidectomy, complications, and revision operations were analyzed. Eustachian tube function was analyzed according to the results of the Eustachian tube test. The status of the middle ear mucosa was described as either 'healthy' or 'inflamed' according to the operation records. Demographic data are presented in Table 1. Analysis of audiologic data Preoperative and postoperative hearing results were evaluated according to the guidelines of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head Neck Surgery Foundation13) an... Background and Objectives: Absence of incus is one of the most common ossicular anomalies and also frequently found in chronic otitis media or chornic otitis media with cholesteatoma. Ossiculoplasty with malleus footplate assembly (MFA) can be an excellent option in the above situations. We reviewed our procedures and evaluated the hearing results of ossiculoplasty using the MFA. Subjects and Methods: This study retrospectively reviews a series of 32 patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in an academic tertiary referral center. The autologous incus or hydroxyapatite (HA) was used as materials for reconstruction. Results: Thirteen of 32 patients (40.6%) had ossicular chain anomaly, 9 patients (28.1%) had congenital cholesteatoma and 8 patients (25.0%) had chronic otitis media with cholesteatoma and 2 patients (6.3%) had chronic otitis media. The patients with ossicular chain anomaly showed the greatest air-bone gap (ABG) closure. Overall, postoperative ABG was 17.7±11.7 dB at postoperative 6 months and 19.7±14.3 dB at postoperative 1 year, compared with preoperative ABG of 37.9±9.3 dB. There was no statistical difference of ABG at postoperative 12 months, 24 months between MFA using incus (n=17) and HA (n=15)(p=0.300, and p=0.563). There was no meaningful difference of postoperative ABG between the patients with combined mastoidectomy (n=10) and those without mastoidecmoy (n=22)(p=0.555). No extrusions occurred.

      • 퇴비 및 부산물 비료의 시비량에 따른 잎들깨의 생장특성

        박선일,정대수,하상영 東亞大學校 1999 東亞論叢 Vol.36 No.-

        잎들깨에 유기질 퇴비와 부산물 비료를 시비량의 차이에 따라 재배한 생장의 특성을 조사한 결과를 요약하면 다음과 같다. 초장은 퇴비나 부산물 비료의 종류에 구별없이 시비량이 증가하면 초장이 생장에 기여하며, 엽의 길이에는 인분분박과 구비에서 길이의 신장이 우수하였으며, 엽폭은 명신바이오에서 넓어지는 현상이 있고 4종류의 비료는 비슷하며, 엽의 건물비율은 시비량이 증가하면 건물비율이 증가하는 현상이 있으나 순수동화량의 생산량을 결정하는 환경요인이 관여하는 것으로 판단되고, 엽내의 무기원소의 함량은 분석한 무기원소의 함량은 모두가 비슷하였고, S는 모든 엽에서 함량이 적었다. This study was conducted to elucidate the growth characteristics of perilla by fertilizer level of manure and organic compost. In this study, as the fertilizer level of manure and organic compost increased, height of perilla was increased. Leaf length was the longest in human manure and cattle manure, and leaf width was the widest in Myoungsin-Bio. As the fertilizer level increased, the rate of dried leaf weight was increased, but the real assimilation quantity was decided by environmental factor. There were no difference in the content of inorganic element of the perilla leaf. However, S in the leaf was low.

      • 위치제어계에서 외란관측기 설계에 관한 연구

        박선국,이상관,최부귀,하홍곤 동아대학교 공과대학 부설 한국자원개발연구소 1991 硏究報告 Vol.15 No.1

        The dynamics of the Multi―degree of freedom manipulator is highly nonlinear and the compensation against this nonlinearity should be indispensable. This paper proposes the decentralized joint control method based on the distrubance observer where the dynamical equation is not directly solved. This system has excellent performance of disturbance supression, because the total acceleration including the load torque and various kinds of frictional torques can be controlled directly, come experiments show the effectiveness of the proposed system. This paper discuss the important relationships with the feedforward compensation type Servo system using distrubance torque observer.

      • 균열밀도에 따른 RC교량의 내하력 평가 및 수명 예측

        박길현,황선화,박종환 朝鮮大學校 建設技術硏究所 2006 建設技術硏究 Vol.26 No.1

        There are several causes, the Percussion from the exterior, the decline of capacity by circumstances, the crack occurred in the interior, the carbonation and soon, that can shorten the span of the concreted construction. And crack density of bridge structures gets higher when they are deteriorated because the concrete crack is the problem of usability. Higher crack density cause the higher bending moment and lower load carrying capacity. In this reason, crack investigation was executed to understand the relation among the degree of degradation caused by the crack occurred on reinforced concrete structures and deflections ratio and load carrying capacity. Deflections ratio and decrease percentage of load carrying capacity of the structures were statistcally analyzed when medium crack which has crack width over O.lmm generated. However, the crack itself, as the primary factor of the life-curtailment of concreted construction, is principal and should bring about the erosion of the reinforcing rod and the span of life.

      • 벽오동(Firmiana sirmlex W.F.Wight) 가지의 수용성 추출액이 작물발아에 미치는 Allelopathy의 효과

        박현철,박선일,하상영 東亞大學校生命資源科學大學附設 農業資源硏究所 1997 農業生命資援硏究 Vol.6 No.1

        벽오동나무 2년, 3년생 가지를 1월과 4월에 채취하여 수용성 추출액을 희석 농도별 공여작물에 발아 실험하여 Allelopahy의 효과를 조사항목별 결과는 다음과 같다. 발아율은 시료의 년별, 월별에 있어 년별 또 토마토, 벼는 월별 발아억제 효과가 없고 월별은 배추, 갓은 1월에 발아율이 낮았으며, 발아기는 벼가 제일 빨랐으며, 다른 공여작물은 무처리에 비하여 2배 내지 3배 정도의 기간이 더 지연되었으며 발아평균기간은 년수에 관계없이 배추, 갓, 벼는 1월이 지연되었으며, 토마토는 오히려 4월은 지연되었다. 발아양부는 벼를 제외한 공여작물은 4월 채취가 발아양부가 양이었으며, 1월은 불량이 많았다. 농도 30%에서는 중, 불량이었으며, 벼는 년수, 월별, 농도에 관계없이 지수가 양이었다. Two and three years old branches of a Phoenix tree were respectively collected on January and April, and the aqueous extract from the branches was then treated to four tested crops, Chinese cabbage, leaf mustard, tomato and rice, in order to find the allelopathic effects by different concentration of the extracts. Generally, there were allelopathic effects of the aqueous extracts on the tested crops with increment of concentration and regardless of branch ages and/or collecting season. The results were summarized as follows. Germination rate of Chinese cabbage and leaf mustard were lower with treatment of the extracts from the branches which were collected on January. Otherwise, there were no significant effects of the extracts on the germination of tomato and rice. Germination time of rice were greater than other crops which germination time were delayed. Average germination time of Chinese cabbage, leaf mustard and rice were delayed with value of tomato was delayed with treatment of the extracts from the branches collected on April. State of germination of all crops, except rice were high with treatment of the extract on April, and were low on January. In case of rice, it was high without regard to the collection season of branches and concentration of extracts.

      • 영동지역 주요 3개 하천의 수질실태 및 관리에 관한 연구

        박광하,민선홍,최봉종,전방욱 강릉대학교동해안지역연구소 1994 東海岸硏究 Vol.5 No.1

        영동지방의 주요 3개 하천의 수질을 조사하고 QUAL-2E 모델을 적용하여 보았다. 강릉남대천은 각 수질항목에서 시기별, 정점별로 큰 차이를 보였으며, 일반적으로 상류의 수질은 하류로 갈수록 생활오수의 유입으로 수질이 악화되는 전형적인 양상을 나타내었다. 양양남대천은 강릉남대천 및 삼척오십천에 비하여 시기별 변이폭이 좁았으며 각 정점별의 수질도 양호한 것으로 나타났다. 삼척오십천은 시기별보다는 정점별 수질차이가 크게 나타났으며 오염된 상류의 수질이 자정작용에 의하여 개선되다가 다시 생활오수의 유입으로 인하여 악화되는 특이한 양상을 보였다. 모델링 결과 하천의 유속, 유량등의 실측 자료가 부족함에도 불구하고 강릉남대천과 양양남대천은 실측치와 예상치가 높은 상관관계를 나타내었다. 또한 이 모델을 사용하여 강릉남대천의 수질예측을 시도하였다. The water quality was monitored and QUAL-2E modelling was applied in three main stream of Youngdong area. Kangnung Namdaecheon was shown to be a typical stream that the downstream water quality was worse than in the upperstream. Water quality of Yangyang Namdaecheon was better than that of Kangnung Namdaecheon and Samchuk Osipcheon. The spatial variation of water quality was greater than the temporal variation in Samchuk Osipcheon: the polluted upperstream water got better in the midstream, but got worse gain in the downstream. Despite of the lack of suitable measurement data, Kangnung Namdaecheon and Ynagyang Namdaecheon showed good relationship between measured and obtained data: however Samchuk Osipcheon, which had many point sources and much pollution load, showed poor relationship. Based on this model, future water quality of Kangnung Namdaecheon was prospected.

      • KCI등재후보

        가토에서 Pentoxifylline, Asprin 및 Heparin이 피부피판의 생존 및 출혈 경향에 미치는 영향

        하주원,백승,박홍주,오희균,유선열 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.5

        The skin flap, which has been frequently used in the maxillofacial soft tissue defects, can be failed due to insufficient blood supply to the flap. To increase its survival rate, antithrombotic agents has been used. The agents have, however, been restrictly used because of their side effects, such as bleeding tendency or hematoma formation on the operation site. The present study aimed to the effect of pentoxifylline, aspirin, and heparin on the skin flap survival rate and bleeding tendency. Twelve adult white rabbits, weighing about 2.0 ㎏, were used. Five random skin flaps, which is 1㎜ thickness, were prepared on the dorsal surface of each rabbit by using 1.5×7.5㎝ prefabricated template. The animals were divided into 4 groups on the basis of drugs used: Control group, animals in which no drug was given (n=3); Pentoxifylline group, animals in which pentoxifylline was given intraorally (n=3); Aspirin group, animals in which aspirin was given intravenously (n=3), and Heparin group, animals in which heparin was given intravenously (n=3). On the 3rd and 7th day after operation, prothrombin time (PT) and activated partial thromboplastin time (aPTT) were measured to evaluate the bleeding tendency. The animals were sacrificed on the 7th day and the mean skin falp survival rate of each group was measured. The results obtained were as follows : The skin flap survival rates of pentoxifylline (84.3±7.9%) and heparin (79.5±10.9%) groups were significantly increased, compared with control group (68.0±10.8%)(P<0.05). The survival rate of aspirin group (73.0±11.1%) was not increased. In bleeding tendency, the PT values were prolonged in heparin and aspirin groups at the 3rd day after operation (P<0.05), and prolonged in order of heparin group, aspirin group, and pentoxifylline group at the 7th day after operation. The aPPT values in heparin and aspirin groups were also prolonged at the 3rd day after operation (P<0.05), and prolonged in order of Aspirin group, Heparin group, and Pentoxifylline group at the 7th day after operation. These results suggest that pentoxifylline may be the most useful drug among three drugs to increase skin falp survival rate and less increase the bleeding tendency.

      • 의사결정 방법에 의한 철근콘크리트 구조물의 상태평가

        박길현,황선화,유동원 朝鮮大學校 建設技術硏究所 2006 建設技術硏究 Vol.26 No.1

        In this study, a method based on the Analytic Hierarchy Process for systematizing the maintenance and securing the safety of the reinforce concrete bridges using an appearance inspection and state evaluation was proposed. It would be possible for general structure engineers to appraise the bridges with this method. Results from periodical inspections are mostly qualitative because of the inspector's subjective judgment. Therefore, for more objectivity of the results from the safety inspections. quantitative standardization processes of the appraisal items areessentially required. Properties of the selected items were standardized with reference to the existing research results and actual data. As for the item thatis difficult to represent quantitatively, word variable of the Analytic Hierarchy Process was introduced and standardized so that the objectivity of the subjective valuation was acquired. Results from this study are as followed. It is possible to acquire very reliable appraisal results of the reinforce concrete bridges according to the Analytic Hierarchy Process defined in this study. Result from this study can be applied practically through the application and analysis of the appraisal technique and the procedure with actual data. Verification through the practical uses and improvements are required for the development in this field.

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