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OBJECTIVE To evaluate the treatment outcomes of nimodipine and steroid combination therapy for idiopathic sudden sensorineural hearing loss (ISSNHL). STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS Seventy-eight patients who were diagnosed with ISSNHL were divided into two group based on the treatment strategies used: steroid+nimodipine (SN, n = 36) and steroid only (SO, n = 42) groups. Based on the level of hearing loss before treatment, subgroup analysis (

To compare hearing recovery levels after initial treatment or salvage intratympanic dexamethasone injection (ITDI), and to find the prognostic factor on salvage ITDI therapy in profound ISSNHL. We retrospectively reviewed 115 patients with profound ISSNHL. All patients were treated with combination or systemic steroid therapy as the initial treatment. Next, we used salvage ITDI therapy on patients who showed slight or no improvement according to Siegel’s criteria. To find the prognostic factors for the effectiveness of salvage ITDI therapy, we analyzed clinical data, such as, age, sex, vertigo, symptom duration, diabetes, hypertension, initial PTA, pre-salvage PTA, and treatment methods, using multiple regression analyses. The rate of serviceable hearing recovery were 10.4% (12/115) in the initial-treatment group and 20.4% (21/103) in the salvage group. The difference was statistically significant (p = 0.041). Pre-salvage PTA, diabetes mellitus, and symptom duration were affective factors for the effectiveness of salvage ITDI therapy in profound ISSNHL refractory to initial treatment, with odds ratios of 1.169 (95% confidence interval, 1.088–1.256), 0.069 (95% confidence interval, 0.005–0.889), and 9.242 (95% confidence interval, 1.079–79.146). Salvage therapy should be considered for profound ISSNHL, which is expected to result in poor prognosis or hearing recovery: ITSI therapy might be an effective treatment as salvage therapy.

Human embryonic stem cells (human ES cells) are pluripotent and self-renewing cells that can be isolated from the inner cell mass at the blastocyst stage. Human ES cells differentiate into specific cell lineages according to the expression of related genes. During neural development, specific gene expressions induced human ES cells some morphological changes. We used suppression subtractive hybridization to identify genes which shows altered expression during neural differentiation from human ES cells. We identified 90 genes as downregulated and 64 genes as upregulated in neural precursor (NP) cells derived from human ES cells compared with human ES cells. To obtain further information about differentiation, we performed expression profiling of subtracted genes between human ES cells and NP cells. Of the subtracted genes in human ES cells, the 19 genes showed decreased expression in NP cells. Meanwhile, of the subtracted genes in NP cells, the 20 genes were upregulated. Among them, COPZ1, CPSF6, MATR3 and TOMD3 were specific gene expressions that they significantly expressed up and down-regulation during neural development derived from ES cells. These genes have not previously been associated with neural differentiation, but they may be potentially participated in neurogenesis.

Recent developments of social virtual reality (VR) services using avatars have increased the need for facial expression recognition (FER) technology. FER systems are generally implemented using optical cameras; however, the performance of these systems can be limited when users are wearing head-mounted displays (HMDs) as users' faces are largely covered by the HMDs. Facial electromyograms (fEMGs) that can be recorded around users' eyes can be potentially used for implementing FER systems for VR applications. However, this technology lacks practicality owing to the need for large-scale training datasets; furthermore, it is hampered by a relatively low performance. In this study, we proposed an fEMG-based FER system based on the Riemannian manifold-based approach to reduce the number of training datasets needed and enhance FER performance. Our experiments with 42 participants showed an average classification accuracy as high as 85.01% for recognizing 11 facial expressions with only a single training dataset for each expression. We further developed an online FER system that could animate a virtual avatar's expression reflecting a user's facial expression in real time, thus demonstrating that our FER system can be potentially used for practical interactive VR applications, such as social VR networks, smart education, and virtual training.

This study aimed to examine the effects of Lactobacillus plantarum, a lactic acid bacteria strain isolated from kimchi, on the development of low-grade inflammation and type 2 diabetes mellitus (T2DM) exacerbated by chronic stress. C57BL/6 mice were fed either a high-fat diet (HFD) and randomized into an HFD group or a group that was fed an HFD and subjected to chronic cold exposure-related stress (HFDS), or mice were fed a normal diet (ND) and randomized into an ND group or a group that was fed an ND and subjected to chronic cold exposure-related stress (NDS). Lactobacillus plantarum LRCC5310 (10(8), 10(10) CFU) and LRCC5314 (10(8), 10(10) CFU) as well as L. gasseri BNR17 (10(8) CFU), as a positive control, were administered orally twice every day to all the mice for 12 weeks. The expression of Glut4 and adiponectin, main glucose transporter-related genes, was upregulated in the LRCC5310- and LRCC5314-treated groups. Levels of serum proinflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6]) and of mRNAs of proinflammatory genes (Tnf-α, Il-6, Ccl2, leptin) were elevated in HFDS mice. The expression of proinflammatory genes was downregulated in LRCC5310- and LRCC5314-treated groups; this was not the case for Tnf-α expression in HFDS mice. Levels of serum corticosterone and mRNA levels of stress-related genes (Npy, Y2r) were decreased in lactic acid bacteria (LAB)-fed groups, with only LRCC5314 downregulating Npy expression in HFDS mice. These results suggest that the LAB strains can normalize the expression of metabolic genes, inhibit inflammatory responses, and suppress stress in HFDS mice.

Glucose metabolism is an important metabolic pathway in the auditory system. Chronic alcohol exposure can cause metabolic dysfunction in auditory cells during hearing loss. While alcohol exposure has been linked to hearing loss, the mechanism by which impaired glycolysis promotes cytotoxicity and cell death in auditory cells remains unclear. Here, we show that the inhibition of epidermal growth factor receptor (EGFR)-induced glycolysis is a critical mechanism for alcohol exposure-induced apoptosis in HEI-OC1 cells. The cytotoxicity via apoptosis was significantly increased by alcohol exposure in HEI-OC1 cells. The glycolytic activity and the levels of hexokinase 1 (HK1) were significantly suppressed by alcohol exposure in HEI-OC1 cells. Mechanistic studies showed that the levels of EGFR and AKT phosphorylation were reduced by alcohol exposure in HEI-OC1 cells. Notably, HK1 expression and glycolytic activity was suppressed by EGFR inhibition in HEI-OC1 cells. These results suggest that impaired glycolysis promotes alcohol exposure-induced apoptosis in HEI-OC1 cells via the inhibition of EGFR signaling.

BACKGROUND Canal switch benign paroxysmal positional vertigo (CS-BPPV) is a transition of BPPV involving one canal to another canal during or after canalith repositioning procedures (CRP). OBJECTIVE To investigate the clinical characteristics of CS-BPPV and its associated factors. METHODS The data of 2,303 patients with BPPV involving the lateral canal (LC) or posterior canal (PC) were retrospectively analyzed. Demographics, etiologies, and various clinical parameters related to CRP were compared between patients with and without CS-BPPV. RESULTS Sixty-eight (2.95%) patients exhibited CS-BPPV. For patients with CS-BPPV from the PC to the LC, as well as those with CS-BPPV from the LC to the PC, the CRP number for the original canal in CS-BPPV was significantly greater than in non-CS-BPPV (P = 0.002). More CRP cycles were required to treat CS-BPPV than non-CS-BPPV involving the same canal. Multivariate analysis showed that CS-BPPV from the LC to the PC was significantly associated with multiple CRP cycles and use of the Gufoni maneuver (P = 0.038 and P

Objectives/Hypothesis We compared the clinical characteristics between acute low- and high-frequency hearing loss (LF and HF, respectively) patients, and the efficacy of three different treatment protocols (systemic steroids, intratympanic steroid injection, and combination therapy). Study Design Prospective, randomized controlled study. Methods A total of 111 patients diagnosed with LF or HF were treated on an outpatient basis. Each group was randomly divided into three equal subgroups based on therapy: oral steroid, intratympanic dexamethasone injection (IT), and combination therapy. Hearing gain was estimated by comparing pre- and post-treatment pure-tone averages. Recovery rate was assessed by Clinical Practice Guideline: Sudden Hearing Loss from the American Academy of Otolaryngology–Head and Neck Surgery. Results In comparison of chief complaints, ear fullness and hearing loss were more common in the LF and HF group, respectively (P = .033 and P = .001, respectively). Hearing recovery rates were significantly different between the two groups (i.e., 74.1% [40/54] in the LF group and 45.6% [26/57] in the HF group; P

Pluripotent stem cells (PSCs) derived from either the embryo or reprogramming processes have the capacity to self-renew and differentiate into various cells in the body, thereby offering a valuable cell source for regenerative therapy of intractable disease and serious tissue damage. Traditionally, methods to expand and differentiate PSCs have been confined to 2D culture through the use of biochemical signals; the use of biomaterials beyond the commercially available culture dish has not been widespread. Nevertheless, biomaterials with tailored physical, chemical, and geometrical cues can mimic the native stem cell niche to tune the microenvironmental conditions for PSCs to preserve their self-renewal capacity or to switch their phenotype, a status ultimately needed to gain regenerative functions ex vivo and in vivo. Recently efforts to explore biomaterials to regulate PSC behavior have accelerated. The biomaterials properties investigated include surface chemistry, immobilized ligand, nano-/micro-topography, matrix stiffness, geometrical complexity, 3D configuration, and combinations thereof. This review aims to cover the current advances of biomaterials-based control over PSCs, particularly for the preservation of self-renewal capacity as well as for their differentiation into target cells. Furthermore, it aims to suggest future research directions that would facilitate the eventual translation of these advances.

Objectives/Hypothesis Unilateral cochlear implantation has emerged as a widely accepted procedure to treat severe to profound hearing loss, but many studies have reported benefits in terms of speech comprehension when listeners with residual low-frequency hearing in the nonimplanted ear use a hearing aid. Study Design Retrospective study. Methods In this study, we analyzed the speech performance and satisfaction of bimodal hearing according to the residual low-frequency hearing level in the nonimplanted ear. Based on low-frequency pure-tone audiometry (average of 250 Hz and 500 Hz) in the nonimplanted ear, we classified individuals into three groups as follows: group A (under 70 dB), group B (71–90 dB), and group C (over 91 dB). Listeners were tested using the Word Recognition Score, the Korea-Central Institute for Deaf sentence recognition test, and the Korean version of the Hearing Handicap Inventory for the Elderly questionnaire. Results We observed a bimodal benefit when the residual low-frequency threshold was less than 70 dB HL and a greater satisfaction with bimodal hearing compared to cochlear implant alone, when the residual low-frequency threshold was less than 70 dB HL. Conclusions This study supports the benefits of bimodal hearing in listeners with bilateral severe to profound sensorineural hearing loss as standard clinical practice, when the residual low-frequency hearing threshold is under 70 dB in the nonimplanted ear. Level of Evidence 4 Laryngoscope, 126:2817–2822, 2016

This study investigated factors prioritized by speech-language pathologists (SLPs) and caregivers for telehealth services involving speech-language assessments and interventions and determined whether the priorities differed between SLPs and caregivers in Korea. The survey data obtained from 23 SLPs and 50 caregivers were analyzed using analytic hierarchical process (AHP) methodology. The results showed that the “SLP” category was the most important high-level category and “building rapport with the child client” in the “SLP” category was of the highest priorities for both SLPs and caregivers across all factors. Furthermore, the rank-order of a few categories and the global priority between SLPs and caregivers varied slightly. These findings suggest that, in addition to important factors associated with SLPs and caregivers, the different expectations of service providers and clients using telepractice in Korea should be addressed.

OBJECTIVES To analyze risk factors for acute low-frequency hearing loss (ALFHL), and compare treatment outcomes in the presence or absence of such risk factors. STUDY DESIGN A case series featuring retrospective chart review. SETTING An academic university hospital. PATIENTS We included 170 ALFHL patients without vertigo. All of the patients received one of four treatments: low-dose steroid (LD-steroid), high-dose steroid (HD-steroid), LD-steroid and diuretics (LD-combination therapy), and ITDI (intratympanic dexamethasone injection) and diuretics (ITDI-combination therapy). To identify risk factors, we reviewed the clinical features of patients such as age, sex, chief complaint, accompanying symptoms, diabetes, hypertension, time from disease onset, the extent of hearing loss, treatment methods, and 1 kHz involvement. INTERVENTIONS ALFHL was diagnosed based on the average hearing loss >30 dB at 250 and 500 Hz. RESULTS The overall rates of hearing recovery were 70-80% in the four treatment groups. In terms of the prognosis of ALFHL patients, we found that a longer time from disease onset and 1 kHz involvement were independent risk factors for poor prognosis. In addition, we compared treatment outcomes of four treatment methods in the presence or absence of risk factors. In ALFHL patients with risk factors, we found statistically significant differences (p = 0.042) among treatment methods; effectiveness ranged in the order if ITDI-combination therapy, LD-combination therapy, HD-steroid, and LD-steroid. CONCLUSIONS Risk factors for poor hearing recovery in ALFHL included longer symptom duration and 1 kHz involvement. In ALFHL with such risk factors, combination therapy was more effective than oral steroid therapy.

The aim of this study was to determine which antibiotic combinations are appropriate for culture-negative hematogenous vertebral osteomyelitis (HVO), based on the antibiotic-susceptibility pattern of organisms isolated from cases of culture-proven HVO. We conducted a retrospective chart review of adult patients with microbiologically proven HVO in five tertiary-care hospitals over a 7-year period. The appropriateness of empiric antibiotic regimens was assessed based on the antibiotic susceptibility profiles of isolated bacteria. In total, 358 cases of microbiologically proven HVO were identified. The main causative pathogens identified were methicillin-susceptible Staphylococcus aureus (33.5%), followed by methicillin-resistant S. aureus (MRSA) (24.9%), aerobic gram-negative bacteria (21.8%), and Streptococcus species (11.7%). Extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and anaerobes accounted for only 1.7% and 1.4%, respectively, of the causative pathogens. Based on the susceptibility results of isolated organisms, levofloxacin plus rifampicin was appropriate in 73.5%, levofloxacin plus clindamycin in 71.2%, and amoxicillin-clavulanate plus ciprofloxacin in 64.5% of cases. These oral combinations were more appropriate for treating community-acquired HVO (85.8%, 84.0%, and 80.4%, respectively) than healthcare-associated HVO (52.6%, 49.6%, and 37.6%, respectively). Vancomycin combined with ciprofloxacin, ceftriaxone, ceftazidime, or cefepime was similarly appropriate (susceptibility rates of 93.0%, 94.1%, 95.8%, and 95.8%, respectively). In conclusion, in a setting with a high prevalence of MRSA HVO, oral antibiotic combinations may be suboptimal for treatment of culture-negative HVO and should be used only in patients with community-acquired HVO. Vancomycin combined with fluoroquinolone or a broad-spectrum cephalosporin was appropriate in most cases of HVO in this study.

OBJECTIVES To review the clinical features of benign paroxysmal positional vertigo (BPPV) secondary to sudden sensorineural hearing loss (SNHL) and to analyze the correlation between canal paresis and the effectiveness of canalith repositioning procedures (CRPs) for the treatment. DESIGN Study case series with chart review. SETTING Academic university hospital. PATIENTS We retrospectively reviewed 277 patients with BPPV. For sudden SNHL with a recent vertigo, patients underwent electronystagmography and bithermal caloric tests. We investigated the clinical characteristics including causes, type of involved semicircular canal, frequency of CRPs, treatment results, and canal paresis (CP). INTERVENTIONS The diagnosis of BPPV accompanied by same-sided sudden SNHL was based on the results of head roll and Dix-Hallpike tests. RESULTS Of 277 patients with BPPV, 24 (8.7%) had sudden SNHL. Multiple-canal involvement most commonly developed in post-sudden SNHL BPPV (p

Co-delivery strategy using multifunctional nanocarriers is an attractive option for the synergistic and enhanced effects in cancer treatment, but one system integrating multiple functions for controlled release at the target is still challenging. Herein, this study shows the synthesis and characterization of our stimulus-responsive co-delivery system for the controlled release into tumors, which is composed of polyethylenimine (PEI)-linked Pluronic F127 (PF127) and folic acid (FA), called PF127-PEI-FA. PF127-PEI-FA system facilitated drug loading and gene complex formation, and showed controlled release behaviors in response to hitting temperature to hyperthermia. PF127-PEI-FA system was demonstrated to be biocompatible and showed receptor-mediated gene delivery. The results of our multifunctional nanocarrier system that enabled co-delivery suggest a promising potential for controlled drug release at targeted areas. However, further in-depth studies on the use of therapeutic drugs and genes in multiple cell types and the animal response are required.

To define the risk factors and adverse effects associated with repeated canalith repositioning procedures (CRPs).A case series featuring chart review.An academic university hospital.We retrospectively reviewed 1900 patients (average age, 54.9 years; range, 11-88 years) diagnosed with benign paroxysmal positional vertigo (BPPV). All underwent repeated CRPs. We recorded clinical features including age, gender, BPPV cause (idiopathic or secondary), symptom duration, the canal involved, the number of sessions of CRP, recurrence, follow-up duration, and complications. We compared these factors using Pearson's chi-squared test and multiple linear regression analysis with dummy variables.BPPV was diagnosed based on the results of the head roll and Dix-Hallpike tests.The overall BPPV resolution rate for patients treated with repeated CRPs was 96.4%. The risk factors for the need for multiple CRPs in BPPV were the duration of vertigo before treatment (β = 0.326, p 0.001), the type of canal involved (β = 0.130, p 0.001), and age (β = 0.040, p = 0.040). The explanatory power of the regression model attained 46.0% (F = 172.510, p 0.001). The failure rate of repeated CRPs was 3.6% and complications included canal conversion (3.1%), nausea (46.4%), vomiting (4.9%), head heaviness (50.8%), imbalance (31.9%), and hypotension or palpitations (8.6%). However, almost all patients recovered.The risk factors associated with the need for Multiple CRPs were as follows: longer duration of vertigo before treatment, bilateral or multiple canal involved, and age50 years.

We report on the effect of sodium on the structure, chemical degradation and bioactivity of glasses in the CaO-MgO-SiO2-P2O5-CaF2 system. The Si-29 and P-31 magic angle spinning-nuclear magnetic resonance spectroscopy of melt-quenched glasses with varying Na2O/MgO ratios exhibit a silicate glass network with the dominance of Q(2)(Si) units and phosphorus mainly forming orthophosphate species. Sodium incorporation in the glasses did not induce a significant structural change in the silicate network, while it did influence the phosphate environment due to its lower ionic field strength in comparison with that of magnesium. The apatite forming ability of glasses has been investigated by immersion of glass powders in simulated body fluid (SBF) for time durations varying between 1 h and 7 days while their chemical degradation has been studied in Tris-HCL in accordance with ISO-10993-14. Increasing Na+/Mg2+ ratio caused a decrease in the chemical durability of glasses and in the apatite forming ability especially during initial steps of interaction between glass and SBF solution. The cellular responses were observed in vitro on bulk glass samples using mouse-derived pre-osteoblastic MC3T3-E1 cell line. The preliminary study suggested that the increasing alkali-concentration in glasses led to cytotoxicity in the cell culture medium. (C) 2014 Elsevier B.V. All rights reserved.

Stimuli-responsiveness is an important characteristic of nanocarriers that can deliver therapeutic molecules in a controlled and on-demand manner. In particular, temperature-responsive micelles have recently gained increasing attention for use in diverse therapeutic areas, including hyperthermia therapy. Herein, we developed novel shell cross-linked Pluronic F127 (PF127) polymers with branched polyethylenimine (PEI), called FPEI, for temperature-triggered drug delivery and gene transfection. The successful synthesis of FPEI copolymers was confirmed by Fourier-transform infrared spectroscopy, with the weight percent of PEI in the FPEI copolymers being 7.5%. The critical micelle concentration of FPEI and PF127 copolymers was shown to be 0.013 and 0.03 mg ml−1 at room temperature, respectively. When Nile Red (NR), used as a hydrophobic model drug, was loaded into FPEI copolymers, the appropriate concentration of NR was 3 and 5 μg ml−1 in 5 and 10 mg ml−1 of FPEI, respectively. Interestingly, the loading capacity of FPEI increased with an increase in the micelle concentration. With increasing temperature, the NR release from the micelle increased, while the micelle radii of FPEI, NR-loaded FPEI, and NR-loaded FPEI–DNA decreased. The DNA binding ability of FPEI copolymers increased with an increase in the N/P ratio. FPEI cytotoxicity in HeLa cells showed a similar tendency, when equivalent PEI amount in FPEI was treated. While further in-depth studies remain as to the in vitro and in vivo biological functions, the FPEI system demonstrated well temperature-triggered NR release into HeLa cells, along with sufficient transfection of plasmid green fluorescence protein, which suggested potential usefulness in temperature-responsive therapy.

Cellular senescence is an irreversible cell cycle arrest that limits the replicative lifespan of cells. Senescence suppresses development of tumors by regulating aging factors, such as cyclin dependent kinase inhibitor (CKI) and telomerase. Suppression subtractive hybridization (SSH) was used to identify genes that were differentially expressed between young human mesenchymal stem cells (Y-hMSCs) and senescent human mesenchymal stem cells (S-hMSCs). We selected positive clones that were functionally characterized by referring to public databases using NCBI BLAST tool. This search revealed that 19 genes were downregulated, and 43 genes were upregulated in S-hMSCs relative to Y-hMSCs. Among subtracted clones in Y-hMSCs, most of genes markedly were related to metabolic functions. These genes, PDIA3, WDR1, FSTL1, COPG1, LMAN1, and PDIA6, significantly downregulated. Conversely, genes for subtracted clones in S-hMSCs were mostly associated with cell adhesion. In particular, the expression levels of 9 genes, HSP90B1, EID1, ATP2B4, DDAH1, PRNP, RAB1A, PGS5, TM4SF1 and SSR3, gradually increased during senescence. These genes have not previously been identified as being related to cellular senescence, but they seemed to be potentially affected during cellular senescence.

Objectives/Hypothesis The purpose of this study is to investigate the effectiveness of intratympanic dexamethasone injections (ITDI) for refractory tinnitus. Study Design A prospective, placebo-controlled, randomized, double-blind study. Methods Thirty patients with refractory tinnitus who were diagnosed in the Department of Otolaryngology, Ajou University Hospital, Suwon, Republic of Korea, between 2006 and 2007 were enrolled and then were assigned into two groups of ITDI (15 patients) or saline (15 patients) by permuted block randomization. Intratympanic injections were double-blind performed four times within 2 weeks. After 4 weeks, we analyzed the improvement and aggravation rates of tinnitus using the following parameters: questionnaires, tinnitus handicap index (THI), loudness matching test, frequency, and duration of tinnitus. Results The effectiveness rates of ITDI for refractory tinnitus reported in the tinnitus questionnaires, in the THI, and in the loudness matching test were all 33.3% in the steroid group, and 26.7%, 40.0%, and 26.7% in the saline group, respectively. However, there were no statistically significant differences in both groups. To analyze the therapeutic effect of ITDI on tinnitus under 6 months of its development, the improvement rates reported in the tinnitus questionnaires, in the THI, and in the loudness matching test were all 28.5% in the steroid group, and 40.0%, 40.0%, and 30.0% in the saline group, respectively. There were also no statistically significant differences in both groups. Conclusions ITDI may not be effective for refractory tinnitus. The indication of ITDI for tinnitus needs to be limited to specific cases. Level of Evidence 1b. Laryngoscope, 123:2817–2822, 2013

In order to develop novel, effective therapies for central nervous system regeneration, it is essential to better understand the role of neurotrophic factors and to design, accordingly, better artificial scaffolds to support both neurite outgrowth and synapse formation. Both nerve growth factor and brain-derived neurotrophic factor are major factors in neural survival, development, synaptogenesis, and synaptic connectivity of primary cultured neurons. As a prime candidate coating material for such neural cultures, carbon nanotubes offer unique structural, mechanical, and electrical properties. In this study, carbon nanotubes coated glass-coverslips were used as the matrix of a primary neural culture system used to investigate the effects of carbon nanotubes on neurite outgrowth and nerve growth factor/brain-derived neurotrophic factor release and expression. For these purposes, we performed comparative analyses of primary cultured neurons on carbon nanotubes coated, non-coated, and Matrigel-coated coverslips. The morphological findings showed definite carbon nanotubes effects on the neurite outgrowths and synaptogenic figures in both cortical and hippocampal neurons when compared with the non-coated negative control. Although the carbon nanotubes did not change neurotrophin expression levels, it stimulated brain-derived neurotrophic factor release into the media from both types of neurons. Accordingly, we suggest a different mechanism of action between carbon nanotubes and Matrigel in relation to the specific neurotrophic factors. Since carbon nanotubes supply long-term extracellular molecular cues for the survival and neurite outgrowths of cultured neurons, the results from this study will contribute to an understanding of carbon nanotubes biological effects and provide new insight into their role in the secretion of neurotrophic factors.

We compared the clinical characteristics between acute low- and high-frequency hearing loss (LF and HF, respectively) patients, and the efficacy of three different treatment protocols (systemic steroids, intratympanic steroid injection, and combination therapy).Prospective, randomized controlled study.A total of 111 patients diagnosed with LF or HF were treated on an outpatient basis. Each group was randomly divided into three equal subgroups based on therapy: oral steroid, intratympanic dexamethasone injection (IT), and combination therapy. Hearing gain was estimated by comparing pre- and post-treatment pure-tone averages. Recovery rate was assessed by Clinical Practice Guideline: Sudden Hearing Loss from the American Academy of Otolaryngology-Head and Neck Surgery.In comparison of chief complaints, ear fullness and hearing loss were more common in the LF and HF group, respectively (P = .033 and P = .001, respectively). Hearing recovery rates were significantly different between the two groups (i.e., 74.1% [40/54] in the LF group and 45.6% [26/57] in the HF group; P .001). Oral steroid therapy was most effective in the LF group (P = .017). In the HF group, all three modalities showed similar results, although IT tended to be the most effective (P = .390).There were differences in chief complaints and treatment responses between LF and HF patients. Although they showed similar partial damage in the cochlea, the pathophysiology of LF and HF may be quite different.1b. Laryngoscope, 127:1878-1884, 2017.

Development of bone scaffolds with excellent osteogenic potential is highly important for stem cell-based bone engineering. Here we developed novel scaffolds made of poly(lactic acid) (PLA) biopolymer with bioactive glass nanocomponent. In vitro bone bioactivity and osteogenic potential of the nanocomposite scaffolds were determined using bone marrow mesenchymal stem cells. Glass nanocomponent was evenly embedded within the PLA matrix while preserving the scaffold pore structure. Simulated body fluid (SBF) test revealed rapid induction of bone mineral-like apatite over the surface of the nanocomposite scaffold, which was not readily observed in the PLA. Cells adhered well onto the nanocomposite scaffold and multiplied during culture period. Nanocomposite scaffold significantly stimulated alkaline phosphatase (ALP) activity and the expression of bone-associated genes (collagen I, ALP, osteopontin and osteocalcin) with respect to PLA. Western blot analysis confirmed the osteogenic protein level was also higher on the nanocomposite scaffold. Results suggest that the nanocomposite scaffolds provide favorable conditions for osteogenesis of MSCs and thus find potential uses in bone tissue engineering.

ObjectivesWe treated patients with idiopathic sudden sensorineural hearing loss (ISSNHL) with several protocols on an outpatient department (OPD) basis. The study compared the efficacy of 3 different steroid treatments for ISSNHL.Study DesignA prospective randomized controlled study.SettingTertiary referral center.MethodsA total of 60 patients diagnosed with ISSNHL were treated through OPD. They were randomly and equally divided into 3 groups based on therapy: oral steroid for 10 days (group I), intratympanic dexamethasone injection (ITDI) 4 times (group II), and both (group III). Pure-tone average (PTA) was measured by taking 4 frequencies (0.5, 1, 2, and 3 kHz). Hearing change was evaluated by comparing pre- and posttreatment PTAs. Recovery rate was assessed by American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Clinical Practice Guidelines.ResultsThe hearing gain was 12.8 ± 15.4 decibels (dB) in group I, 12.1 ± 14.6 dB in group II, and 21.9 ± 26.2 dB in group III. The recovery rate was 6...

ObjectivesTo identify clinical features and causes of recurrent or persistent benign paroxysmal positional vertigo (BPPV) and to analyze the effectiveness of frequently repeated canalith repositioning procedures (CRPs).Study DesignCase series with chart review.SettingAcademic university hospital.MethodsThe authors retrospectively reviewed the clinical records of 120 patients who were diagnosed with BPPV at the Dizziness Clinic in Ajou University Hospital, Korea, between 2004 and 2008. “Persistent” and “recurrent” BPPV were respectively defined as BPPV continuing more than 2 weeks and recurring BPPV in the same canals after at least 2 weeks of a symptom-free interval following previous successful treatments. The authors treated patients with frequently repeated CRPs such as the modified Epley maneuver or a barbecue rotation every 2 or 3 days in the outpatient clinic.ResultsAmong 120 patients with BPPV, 93 (77.5%) were typical, 15 (12.5%) were persistent, and 12 (10.0%) were recurrent. Although the most com...

Tissue engineering of stem cells in concert with 3-dimensional (3D) scaffolds is a promising approach for regeneration of bone tissues. Bioactive ceramic microspheres are considered effective 3D stem cell carriers for bone tissue engineering. Here we used evacuated calcium phosphate (CaP) microspheres as the carrier of mesenchymal stem cells (MSCs) derived from rat bone marrow. The performance of the CaP-MSCs construct in bone formation within a rat calvarium defect was evaluated. MSCs were first cultured in combination with the evacuated microcarriers for 7 days in an osteogenic medium, which was then implanted in the 6 mm-diameter calvarium defect for 12 weeks. For comparison purposes, a control defect and cell-free CaP microspheres were also evaluated. The osteogenic differentiation of MSCs cultivated in the evacuated CaP microcarriers was confirmed by alkaline phosphatase staining and real time polymerase chain reaction. The in vivo results confirmed the highest bone formation was attained in the CaP microcarriers combined with MSCs, based on microcomputed tomography and histological assays. The results suggest that evacuated CaP microspheres have the potential to be useful as stem cell carriers for bone tissue engineering.

Objective To determine whether cochlear hydrops analysis masking procedure (CHAMP) has diagnostic value in patients with definite Meniere’s disease (MD) comparing the diagnostic validity index of CHAMP with those of electrocochleography (ECoG). Study Design A prospective study. Setting Tertiary referral center. Patients One hundred eight patients were classified into 3 groups: the “definite MD” group (MD group, n = 47); the “non-MD” group (n = 41) of other vestibular diseases including vestibular neuritis, and benign paroxysmal positional vertigo; and the control group (n = 20), which included patients without dizziness. Interventions CHAMP and extratympanic ECoG were performed in all patients. Main Outcome Measure Sensitivity, specificity, and definitions of abnormal values were less than 0.3 ms in latency delay (0.5 kHz high pass noise [HPN]–click alone) and less than 0.95 in compound amplitude ratio (click alone–0.5 kHz HPN/click alone) in CHAMP and 0.4 for the summating potential/action potential ratio in ECoG. Results The mean latency delay and amplitude ratio of CHAMP in the MD group significantly differed from these values for other groups, whereas the mean summating potential/action potential ratio of ECoG did not. In ECoG, sensitivity was as low as 21%, specificity was 97%, and diagnostic accuracy was 62%. Sensitivity, specificity, and diagnostic accuracy of CHAMP were 64%, 98%, and 80%, respectively, in latency delay and 91%, 83%, and 88%, respectively, in amplitude ratio. The sensitivity and diagnostic accuracy of CHAMP were significantly higher than the corresponding values for ECoG. Conclusion CHAMP is more valuable in detection of definite MD than extratympanic ECoG.

Both surgical tympanoplasty and paper patch grafts are frequently procedured to heal tympanic membrane (TM) perforation or chronic otitis media, despite their many disadvantages. In this study, we report a new healing method of TM perforation by using three-dimensional (3D) porous chitosan scaffolds (3D chitosan scaffolds) as an alternative method to surgical treatment or paper patch graft. Various 3D chitosan scaffolds were prepared; and the structural characteristics, mechanical property, in vitro biocompatibility, and healing effects of the 3D chitosan scaffolds as an artificial TM in in vivo animal studies were investigated. A 3D chitosan scaffold of 5 wt.% chitosan concentration showed good proliferation of TM cells in an in vitro study, as well as suitable structural characteristics and mechanical property, as compared with either 1% or 3% chitosan. In in vivo animal studies, 3D chitosan scaffold were able to migrate through the pores and surfaces of TM cells, thus leading to more effective TM regeneration than paper patch technique. Histological observations demonstrated that the regenerated TM with the 3D chitosan scaffold consisted of three (epidermal, connective tissue, and mucosal) layers and were thicker than normal TMs. The 3D chitosan scaffold technique may be an optimal healing method used in lieu of surgical tympanoplasty in certain cases to heal perforated TMs.

SummaryUndifferentiated stem cells may support a greater development of cloned embryos compared with differentiated cell types due to their ease of reprogramming during the nuclear transfer (NT) process. Hence, stem cells may be more suitable as nuclear donor cells for NT procedures than are somatic cells. Embryonic germ (EG) cells are undifferentiated stem cells that are isolated from cultured primordial germ cells (PGC) and can differentiate into several cell types. In this study, the in vitro development of NT embryos using porcine EG cells and their derivative neural precursor (NP) cells was investigated, thus eliminating any variation in genetic differences. The rates of fusion did not differ between NT embryos from EG and NP cells; however, the rate of cleavage in NT embryos derived from EG cells was significantly higher (p < 0.05) than that from NP cells (141/247 [57.1%] vs. 105/228 [46.1%]). Similarly, the rate of blastocyst development was significantly higher (P < 0.05) in NT using EG cells than the rate using NP cells (43/247 [17.4%] vs. 18/228 [7.9%]). The results obtained from the present study in pigs demonstrate a reduced capability for nuclear donor cells to be reprogrammed following the differentiation of porcine EG cells. Undifferentiated EG cells may be more amenable to reprogramming after reconstruction compared with differentiated somatic cells.

Background/Objectives: The purpose of this study was to investigate the activity of the spinal muscles according to the pelvic tilt angle and to identify the muscles affecting the posture. Methods/Statistical analysis:Thirty healthy young adults participated in this study. The muscle activity and pelvic tilting of the erector spinea were measured using electromyography and inertial sensor. One-way repeated ANOVA was used to compare muscle activity of each muscle according to pelvic tilting angle. Findings: The muscle activity of the three muscles of the spine showed a significant difference between posterior tilting and anterior tilting of the pelvic (p

It has been suggested that connexin (Cx) gap junction proteins act as tumor suppressors and green tea has a potential to prevent tumor development, however, the studies on their association with human keratinocytes were rare. We evaluated the effects of a tumor promoter, phorbol-12-myristate-13-acetate (PMA), on the expression of Cxs and gap junction intercellular communication (GJIC) in human keratinocytes (HaCaT cells) and explored the preventive effects of green tea extracts-epicatechin (EC) and epigallocatechin-3-gallate (EGCG). We performed neutral red dye uptake assay to determine the optimal concentrations of PMA, EC, and EGCG for this study and confirmed the expression of Cx mRNAs using RT-PCR. We evaluated GJIC quantitatively using the 'scrape-loading dye transfer (SLDT)' technique after 24-h culture of HaCaT cells treated with agents. To analyze the expression change of Cxs, we also performed Western blot and immunocytochemistry. HaCaT cells were found to express Cx26, Cx30, Cx31, and Cx43, but not Cx29. In 'scrape-loading dye transfer' for functional study for GJIC, EC and EGCG significantly prevented PMA-induced down-regulation of GJIC. Western blot analyses revealed that EC and EGCG prevented down-regulation of Cx26 and Cx43 proteins in HaCaT cells treated with PMA. Immunocytochemistry showed decreased expression and abnormal location of Cx26 and Cx43 in HaCaT cells when treated with PMA, and EC and EGCG inhibited its effect. These results suggest an important role of GJIC played in carcinogenesis involving human keratinocytes and green tea as a useful anticancer diet.