Chemical composition of Galla chinensis extract and the effect of its main component(s) on the prevention of enamel demineralization in vitro

To determine the chemical composition of Galla chinensis extract(GCE) by several analysis techniques and to compare the efficacy of GCE and its main component(s) in inhibition of enamel demineralization,for the development of future anticaries agents,main organic composition of GCE was qualitatively determined by liquid chromatography-time of flight-mass spectrometry(LC-TOF-MS) and quantified by high-performance liquid chromatography-diode array detector(HPLC-DAD).Inorganic ions were tested by inductively coupled plasma-atomic emission spectroscopy and F was especially measured by ion chromatography.Then,bovine enamel blocks were randomly divided into four treatment groups and were subjected to a pH-cycling regime for 12 times.Each cycle included 5-min applications with one of four treatments:4 g?L 21 GCE solution,4 g?L 21 gallic acid(GA) solution,1 g?L 21 NaF solution(positive control),deionized water(DDW,negative control),and then 60-min application in pH 5.0 acidic buffer and 5-min application in neutral buffer.Acidic buffers were retained for calcium analysis.The main organic composition of GCE were GA and its isomer,and,to a lesser extent,small molecule gallotannins.The content of GA in GCE was 71.3%60.2%(w/w).Inorganic ions were present in various amounts,of which Ca was(13662.82) mg?g 21,and Zn was(6.860.1) mg?g 21.No F was detected in GCE.In pH cycling,GA showed an effect similar to GCE in inhibiting enamel demineralization(P.0.05).GA was found to be the main effective,demineralization inhibiting component of GCE and could be a promising agent for the development of anticaries agents.     

Effect of colouring green stage zirconia on the adhesion of veneering ceramics with different thermal expansion coefficients

This study evaluated the adhesion of zirconia core ceramics with their corresponding veneering ceramics, having different thermal expansion coefficients （TECs）, when zirconia ceramics were coloured at green stage. Zirconia blocks （N=240; 6 mm x 7 mm x 7 mm） were manufactured from two materials namely, ICE Zirconia （Group 1） and Prettau Zirconia （Group 2）. In their green stage, they were randomly divided into two groups. Half of the specimens were coloured with colouring liquid （shade A2）, Three different veneering ceramics with different TEC （ICE Ceramic, GC Initial Zr and IPS e.max Ceram） were fired on both coloured and non-coloured zirconia cores. Specimens of high noble alloys （Esteticor Plus） veneered with ceramic （VM 13） （n= 16） acted as the control group. Core-veneer interface of the specimens were subjected to shear force in the Universal Testing Machine （0.5 mm-min-1）. Neither the zirconia core material （P=0.318） nor colouring （P=0.188） significantly affected the results （three-way analysis of variance, Tukey＇s test）. But the results were significantly affected by the veneering ceramic （P=0.000）. Control group exhibited significantly higher mean bond strength values （45.7__.8） MPa than all other tested groups （（27.1__.4.1）-（39.7__.4.7） and （27.4__.5.6）-（35.9___4.7） MPa with and without colouring, respectively） （P~0.001）. While in zirconia-veneer test groups, predominantly mixed type of failures were observed with the veneering ceramic covering ~ 1/3 of the substrate surface, in the metal-ceramic group, veneering ceramic was left adhered 1/3 of the metal surface. Colouring zirconia did not impair adhesion of veneering ceramic, but veneering ceramic had a significant influence on the core-veneer adhesion. Metal-ceramic adhesion was more reliable than all zirconia-veneer ceramics tested.     

A Genome-Wide Association Study of Chronic Otitis Media with Effusion and Recurrent Otitis Media Identifies a Novel Susceptibility Locus on Chromosome 2

Chronic otitis media with effusion (COME) and recurrent otitis media (ROM) have been shown to be heritable, but candidate gene and linkage studies to date have been equivocal. Our aim was to identify genetic susceptibility factors using a genome-wide association study (GWAS). We genotyped 602 subjects from 143 families with 373 COME/ROM subjects using the Illumina Human CNV370-Duo DNA Bead Chip (324,748 SNPs). We carried out the GWAS scan and imputed SNPs at the regions with the most significant associations. Replication genotyping in an independent family-based sample was conducted for 53 SNPs: the 41 most significant SNPs with P < 10⁻⁴ and 12 imputed SNPs with P < 10⁻⁴ on chromosome 15 (near the strongest signal). We replicated the association of rs10497394 (GWAS discovery P = 1.30 × 10⁻⁵) on chromosome 2 in the independent otitis media population (P = 4.7 × 10⁻⁵; meta-analysis P = 1.52 × 10⁻⁸). Three additional SNPs had replication P values < 0.10. Two were on chromosome 15q26.1 including rs1110060, the strongest association with COME/ROM in the primary GWAS (P = 3.4 ×10⁻⁷) in KIF7 intron 7 (P = 0.072), and rs10775247, a non-synonymous SNP in TICRR exon 2 (P = 0.075). The third SNP rs386057 was on chromosome 5 in TPPP intron 1 (P = 0.045). We have performed the first GWAS of COME/ROM and have identified a SNP rs10497394 on chromosome 2 is significantly associated with COME/ROM susceptibility. This SNP is within a 537 kb intergenic region, bordered by CDCA7 and SP3. The genomic and functional significance of this newly identified locus in COME/ROM pathogenesis requires additional investigation.     

Influence of fiber posts on the fracture resistance of endodontically treated premolars with different dental defects

This study aimed to evaluate the influence of quartz fiber post placement on the fracture resistance of endodontically treated premolars with different dental defects under dynamic loading.Fifty extracted single-rooted mandibular premolars were randomized into five groups.Each group was prepared according to numbers of residual walls ranged from 0 to 4.Then each group was divided into two subgroups with one restored with quartz fiber posts and the other without posts.In no-post groups,gutta percha point 2 mm below cemento-enamel junction was removed.Composite resin was adapted to the well and used to shape the core directly.Each tooth was restored with a complete metal crown.Dynamic loading was carried out in a masticatory simulator with a nominal load of 50 N at 2 Hz for 300 000 loading cycles.Then a quasi-statically load was applied in a universal testing machine 306 to the long axis with a crosshead speed of 1 mm？min21until fracture.Data were analyzed with one-way analysis of variance and pairwise comparison（P,0.05）.No specimens failed during dynamic loading.The fracture resistance enhanced with the increase of numbers of coronal walls and the differences were significant（P,0.05）.Placement of fiber posts had a significant effect when fewer than two walls remained（P,0.05）,but it had no significant influence in groups with two,three or four walls（P.0.05）.Fiber post did not change failure mode,and the fracture pattern was mainly favorable.More dentin walls need to be retained in clinic.When no less than two walls remained,a fiber post is not always necessary.     

Growth inhibitory response and ultrastructural modification of oral-associated candidal reference strains （ATCC） by Piper betle L. extract

Candida species have been associated with the emergence of strains resistant to selected antifungal agents. Plant products have been used traditionally as alternative medicine to ease mucosal fungal infections. This study aimed to investigate the effects of Piper betle extract on the growth profile and the ultrastructure of commonly isolated oral candidal cells. The major component of Po betle was identified using liquid chromatography-mass spectrophotometry （LC-MS/MS）. Seven ATCC control strains of Candida species were cultured in yeast peptone dextrose broth under four different growth environments： （i） in the absence of P. betle extract; and in the presence of P. beUeextract at respective concentrations of （ii） 1 mg.mL-1; （iii） 3 mg.mL-1; and （iv） 6 mg.mL- 1 The growth inhibitory responses of the candidal cells were determined based on changes in the specific growth rates （μ）. Scanning electron microscopy （SEM） was used to observe any ultrastructural alterations in the candida colonies. LC-MS/MS was performed to validate the presence of bioactive compounds in the extract. Following treatment, it was observed that the p-values of the treated cells were significantly different than those of the untreated cells （P〈0.05）, indicating the fungistatic properties of the P. beUe extract. The candidal population was also reduced from an average of 13.44× 10^6 to 1.78×10^6 viable cell counts （CFU）.mL-1, SEM examination exhibited physical damage and considerable morphological alterations of the treated cells. The compound profile from LC-MS/MS indicated the presence of hydroxybenzoic acid, chavibetol and hydroxychavicol in P. betle extract. The effects of P. betle on candida cells could potentiate its antifungal activity.     

Effect of Galla chinensis on the remineralization of two bovine root lesions morphous in vitro

The present study aims to evaluate the effect of Galla chinensis compounds on the remineralization of two artificial root lesions morphous in vitro.Sixty bovine dentine blocks were divided into two groups and individually treated with two levels of demineralization solutions to form erosive and subsurface artificial carious lesions in vitro.Each group was then divided into three subgroups,each of which were treated with a remineralization solution(positive control),deionized water(negative control),or 4 000 mg?L 21 aqueous solutions of Galla chinensis extract.The dentine blocks were then subjected to a pH-cycling regime for 7 days.During the first 4 days,the daily cycle included 21-h deal and 3-h demineralization applications.The dentine blocks were dealt with the entire day during the remaining 3 days.Two specimens from each of the treatment groups were selected and observed under a polarized light microscope.Data collected using a laser scanning confocal microscope were computerized and analyzed.Galla chinensis extract clearly enhanced the remineralization of both erosive lesion and subsurface lesion patterns in the specimens(P,0.05).The level of remineralization of the erosive lesion by Galla chinensis extract was lower than that of the subsurface lesion(P,0.05).In addition,the remineralization of the subsurface lesion by Galla chinensis extract was higher than that of the remineralization solution(P,0.05).No significant difference between the remineralization of erosive lesions by Galla chinensis extract and the remineralization solution was observed(P.0.05).So Galla chinensis extract has the potential to improve the remineralization of artificial root lesions under dynamic pH-cyclic conditions,indicating its potential use as a natural remineralization medicine.     

Isolation and characterisation of human gingival margin-derived STRO-1/MACS~+ and MACS~-cell populations

Recently,gingival margin-derived stem/progenitor cells isolated via STRO-1/magnetic activated cell sorting(MACS) showed remarkable periodontal regenerative potential in vivo.As a second-stage investigation,the present study’s aim was to perform in vitro characterisation and comparison of the stem/progenitor cell characteristics of sorted STRO-1-positive(MACS~+) and STRO-1-negative(MACS~-) cell populations from the human free gingival margin.Cells were isolated from the free gingiva using a minimally invasive technique and were magnetically sorted using anti-STRO-1 antibodies.Subsequently,the MACS~+ and MACS~- cell fractions were characterized by flow cytometry for expression of CD14,CD34,CD45,CD73,CD90,CD105,CD146/MUC18 and STRO-1.Colony-forming unit(CFU) and multilineage differentiation potential were assayed for both cell fractions.Mineralisation marker expression was examined using real-time polymerase chain reaction(PCR).MACS~+ and MACS- cell fractions showed plastic adherence.MACS~+ cells,in contrast to MACS- cells,showed all of the predefined mesenchymal stem/progenitor cell characteristics and a significantly higher number of CFUs(P<0.01).More than 95%of MACS~+ cells expressed CD105,CD90 and CD73;lacked the haematopoietic markers CD45,CD34 and CD14,and expressed STRO-1 and CD146/MUC18.MACS- cells showed a different surface marker expression profile,with almost no expression of CD14 or STRO-1,and more than 95%of these cells expressed CD73,CD90 and CD146/MUC18,as well as the haematopoietic markers CD34 and CD45 and CD105.MACS~+ cells could be differentiated along osteoblastic,adipocytic and chondroblastic lineages.In contrast,MACS- cells demonstrated slight osteogenic potential.Unstimulated MACS~+ cells showed significantly higher expression of collagen I(P<0.05) and collagen III(P<0.01),whereas MACS~- cells demonstrated higher expression of osteonectin(P<0.05;MannWhitney).The present study is the first to compare gingival MACS~+ and MACS- cell populations demonstrating that MACS~+ cells,in contrast to MACS- cells,harbour stem/progenitor cell characteristics.This study also validates the effectiveness of the STRO-l/MACS~+technique for the isolation of gingival stem/progenitor cells.Human free gingival margin-derived STRO-1/MACS~+ cells are a unique renewable source of multipotent stem/progenitor cells.     

Enhanced Vestibulo-ocular Reflex to Electrical Vestibular Stimulation in Meniere’s Disease

Meniere’s disease is characterized by sporadic episodes of vertigo, nystagmus, fluctuating sensorineural hearing loss, tinnitus and aural pressure. Since Meniere’s disease can affect different regions of the vestibular labyrinth, we investigated if electrical vestibular stimulation (EVS) which excites the entire vestibular labyrinth may be useful to reveal patchy endorgan pathology. We recorded three-dimensional electrically evoked vestibulo-ocular reflex (eVOR) to transient EVS using bilateral, bipolar 100-ms current steps at intensities of 0.9, 2.5, 5.0, 7.5 and 10.0 mA with dual-search coils in 12 unilateral Meniere’s patients. Their results were compared to 17 normal subjects. Normal eVOR had tonic and phasic spatiotemporal properties best described by the torsional component, which was four times larger than horizontal and vertical components. At EVS onset and offset of 8.9 ms latency, there were phasic eVOR initiation (M = 1,267 °/s²) and cessation (M = −1,675 °/s²) acceleration pulses, whereas during the constant portion of the EVS, there was a maintained tonic eVOR (M = 9.1 °/s) at 10 mA. However in Meniere’s disease, whilst latency of EVS onset and offset was normal at 9.0 ms, phasic eVOR initiation (M = 1,720 °/s²) and cessation (M = −2,523 °/s²) were enlarged at 10 mA. The initiation profile was a bimodal response, whilst the cessation profile frequently did not return to baseline. The tonic eVOR (M = 20.5 °/s) exhibited a ramped enhancement of about twice normal at 10 mA. Tonic eVOR enhancement was present for EVS >0.9 mA and disproportionately enhanced the torsional, vertical and horizontal components. These eVOR abnormalities may be a diagnostic indicator of Meniere’s disease and may explain the vertigo attacks in the presence of declining mechanically evoked vestibular responses.     

A novel protein-repellent dental composite containing 2-methacryloyloxyethyl phosphorylcholine

Secondary caries due to biofilm acids is a primary cause of dental composite restoration failure.To date,there have been no reports of dental composites that can repel protein adsorption and inhibit bacteria attachment.The objectives of this study were to develop a protein-repellent dental composite by incorporating 2-methacryloyloxyethyl phosphorylcholine(MPC) and to investigate for the first time the effects of MPC mass fraction on protein adsorption,bacteria attachment,biofilm growth,and mechanical properties.Composites were synthesized with 0(control),0.75%,1.5%,2.25%,3%,4.5%and 6%of MPC by mass.A commercial composite was also tested as a control.Mechanical properties were measured in three-point flexure.Protein adsorption onto the composite was determined by the microbicinchoninic acid method.A human saliva microcosm biofilm model was used.Early attachment at 4 h,biofilm at 2 days,live/dead staining and colony-forming units(CFUs) of biofilms grown on the composites were investigated.Composites with MPC of up to 3%had mechanical properties similar to those without MPC and those of the commercial control,whereas 4.5%and 6%MPC decreased the mechanical properties(P<0.05).Increasing MPC from 0 to 3%reduced the protein adsorption on composites(P<0.05).The composite with 3%MPC had protein adsorption that was 1/12 that of the control(P<0.05).Oral bacteria early attachment and biofilm growth were also greatly reduced on the composite with 3%MPC,compared to the control(P<0.05).In conclusion,incorporation of MPC into composites at 3%greatly reduced protein adsorption,bacteria attachment and biofilm CFUs,without compromising mechanical properties.Protein-repellent composites could help to repel bacteria attachment and plaque build-up to reduce secondary caries.The protein-repellent method might be applicable to other dental materials.     

Porous titanium granules in critical size defects of rabbit tibia with or without membranes

Recently, porous titanium granules （PTGs） have been indicated for the preservation of the dimensions of post-extraction sockets, as a filler in sinus lift procedures and for the treatment of peri-implant and periodontal defects, based on the osteoconductivity and dimensional stability of the titanium granules. However, there is a lack of information regarding the use of this material in larger defects and in conjunction with membranes. The objective of this study is to test the behavior of PTGs used to fill critical size defects in rabbit tibiae, with and without membranes. Critical defects were created in both tibiae of rabbits, divided randomly into three groups： Group A （defect filled with PTG）, Group B （defect filled with PTG＋collagen membrane） and a control group （empty defect）. After six weeks, histomorphometric analysis was performed. The results showed more defect closures at the cortical area （87.37%±2.2%） and more bone formation at the marrow area （57.6%± 1.3%） in Group B, in comparison with the other groups （P〈0.05）; the use of membranes improved the material stability expressed as more percentages of the original material when membranes were used （P〈0.05）. Finally, inflammatory reactions were observed when the granules were not protected by membranes. In spite of the limitations of this animal study, it may be concluded that PTG particles are osteoconductive and allow bone growth. The PTG particles must be covered by a membrane, especially when grafting larger defects, in order to control particle migration, promote clot stabilization and separate the PTG graft from undesired soft tissue cells.     

Sensory innervation around immediately vs. delayed loaded implants:a pilot study

Although neurophysiological and psychophysical proof of osseoperception is accumulating, histomorphometric evidence for the neural mechanisms of functional compensation following immediate and delayed ...     

Efficacy of two calcium phosphate pastes on the remineralization of artificial caries： a randomized controlled double-blind in situ study

To test the efficacy of two calcium phosphate pastes compared to that of fluoride toothpaste on remineralizing artificial caries in situ, this study had a double-blind crossover in situ design, involving three experimental phases of 14 days each, with an 8-day washout period between phases. Nine healthy subjects participated in the study. The subjects wore removable palatal appliances mounted with six human enamel slabs with artificial caries lesions, and in each of the experimental phases, used one of the following methods two times/day： group A, brushing with 1.0 g of Colgate Regular Flavor, followed by applying 0.25 g of Tooth Mousse Plus; group B, brushing with 0.25 g of Clinpro Tooth Crbme; and group C, brushing with 1.0 g of Colgate Regular Flavor. After 14 days, the enamel slabs （54 slabs/ group） were embedded in resin, sectioned and examined with a polarized-light microscope, and the lesion areas were quantified using Image-Pro Plus. All experimental groups showed a significant reduction in lesion area compared to the initial lesion area （paired t-test, P〈O.O01）. The mean reduction in lesion area of Groups A, B and C were （0.029__.0.010）, （0.030_＋0.009） and （0.027_＋0.009） mm2, respectively. There were no statistical differences between groups （KruskaI-Wallis test, P〉0.05）. All three groups remineralized the enamel slab lesions, indicating model sensitivity to fluoride. Given the differences in usage amounts and treated regimens, Clinpro Tooth Crbme provided similar benefits to the fluoride toothpaste; however, no additional benefit of Tooth Mousse Plus was observed when used in conjunction with the fluoride toothpaste.     

In vitro analysis of riboflavin-modified,experimental, two-step etch-and-rinse dentin adhesive:Fourier transform infrared spectroscopy and micro-Raman studies

To modify two-step experimental etch-and-rinse dentin adhesive with different concentrations of riboflavin and to study its effect on the bond strength,degree of conversion,along with resin infiltration within the demineralized dentin substrate,an experimental adhesive-system was modified with different concentrations of riboflavin(mlm,0,1%,3%,5%and 10%).Dentin surfaces were etched with 37%phosphoric acid,bonded with respective adhesives,restored with restorative composite-resin,and sectioned into resin-dentin slabs and beams to be stored for 24 h or 9 months in artificial saliva.Micro-tensile bond testing was performed with scanning electron microscopy to analyse the failure of debonded beams.The degree of conversion was evaluated with Fourier transform infrared spectroscopy(FTIR) at different time points along with micro-Raman spectroscopy analysis.Data was analyzed with one-way and two-way analysis of variance followed by Tukey’s for pair-wise comparison.Modification with 1%and 3%riboflavin increased the micro-tensile bond strength compared to the control at 24 h and 9-month storage with no significant differences in degree of conversion(P<0.05).The most predominant failure mode was the mixed fracture among all specimens except 10%riboflavin-modified adhesive specimens where cohesive failure was predominant.Raman analysis revealed that 1%and 3%riboflavin adhesives specimens showed relatively higher resin infiltration.The incorporation of riboflavin in the experimental two-step etch-and-rinse adhesive at 3%(mlm) improved the immediate bond strengths and bond durability after 9-month storage in artificial saliva without adversely affecting the degree of conversion of the adhesive monomers and resin infiltration.     

Hyperpolarization-Activated Current (I h) in Vestibular Calyx Terminals: Characterization and Role in Shaping Postsynaptic Events

Calyx afferent terminals engulf the basolateral region of type I vestibular hair cells, and synaptic transmission across the vestibular type I hair cell/calyx is not well understood. Calyces express several ionic conductances, which may shape postsynaptic potentials. These include previously described tetrodotoxin-sensitive inward Na⁺ currents, voltage-dependent outward K⁺ currents and a K(Ca) current. Here, we characterize an inwardly rectifying conductance in gerbil semicircular canal calyx terminals (postnatal days 3–45), sensitive to voltage and to cyclic nucleotides. Using whole-cell patch clamp, we recorded from isolated calyx terminals still attached to their type I hair cells. A slowly activating, noninactivating current (I_h) was seen with hyperpolarizing voltage steps negative to the resting potential. External Cs⁺ (1–5 mM) and ZD7288 (100 μM) blocked the inward current by 97 and 83 %, respectively, confirming that I_h was carried by hyperpolarization-activated, cyclic nucleotide gated channels. Mean half-activation voltage of I_h was −123 mV, which shifted to −114 mV in the presence of cAMP. Activation of I_h was well described with a third order exponential fit to the current (mean time constant of activation, τ, was 190 ms at −139 mV). Activation speeded up significantly (τ = 136 and 127 ms, respectively) when intracellular cAMP and cGMP were present, suggesting that in vivo I_h could be subject to efferent modulation via cyclic nucleotide-dependent mechanisms. In current clamp, hyperpolarizing current steps produced a time-dependent depolarizing sag followed by either a rebound afterdepolarization or an action potential. Spontaneous excitatory postsynaptic potentials (EPSPs) became larger and wider when I_h was blocked with ZD7288. In a three-dimensional mathematical model of the calyx terminal based on Hodgkin–Huxley type ionic conductances, removal of I_h similarly increased the EPSP, whereas cAMP slightly decreased simulated EPSP size and width.     

Antimicrobial activity of alexidine alone and associated with N-acetylcysteine against Enterococcus faecalis biofilm

The purpose of this study was to assess the efficacy of alexidine（ALX）,alone and combined with N-acetylcysteine（NAC）,in eradicating two Enterococcus faecalis strain biofilms.The biofilms of E.faecalis ATCC 29212 and the clinical isolate E.faecalis D1 were grown in the MBEC-high-throughput device for 24 h and were exposed to five twofold dilutions of ALX（2%–0.007 8%）alone and combined with100 mg？mL21NAC,for 1 and 5 min.Eradication was defined as 100%kill of biofilm bacteria.The Student’s t-test was used to compare the efficacy of the associations of the two irrigants.After 1-min contact time,ALX eradicated the biofilms at all concentrations except for 0.007 8%and 0.015 6%–0.007 8%with E.faecalis ATCC 29212 and E.faecalis D1,respectively.Similar results for eradication and concentration were obtained when it was combined with 100 mg？mL21NAC.After 5 min of contact time,ALX alone and combined with NAC eradicated all enterococci biofilms.ALX showed antimicrobial properties against the two E.faecalis strain biofilms tested at very low concentrations,and its combined use with NAC was not seen to enhance its activity.     

Association between routine hematological parameters and sudden sensorineural hearing loss: A meta-analysis

Objective:Recent studies have shown that chronic inflammation contributes to the development of sudden sensorineural hearing loss(SSNHL).Some hematologic parameters have also been linked to the prognosis of SSNHL.However,the prognostic value of such hematological factors is not conclusive.This study explored the association of routine hematological parameters with SSNHL.Methods:A systematic literature search was conducted in PubMed,Cochrane Library,Web of Science and Embase to identify eligible studies.Standardized mean deviation(SMD)and the 95%confidence interval(CI)were retried from relevant studies for analysis.Heterogeneity,subgroup,and publication bias analyses were performed.Results:A total of 18 studies involving 1505 SSNHL patients and 1466 healthy persons were enrolled in the final analysis.The study population included 699 responders and 458 non-responders to treatment.Pooled results revealed that the neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)value in the SSNHL patient group were higher than in the healthy group(SMD=1.05,95%CI:0.86,1.24,p<0.001,SMD=0.52,95%CI:0.26,0.78,p<0.001,respectively).However,there was no significant difference in the mean platelet volumes(MPV)between the groups(SMD=0.03,95%CI:0.44,0.49,p=0.91).Notably,NLR and PLR values were evidently higher in the unrecovered group than in the recovered group(SMD=0.63,95%CI:1.02,0.23,p=0.002,SMD=0.4,95%CI:0.76,0.03,p=0.03,respectively).However,the MPV value was similar in both groups(SMD=0.35,95%CI:1.14,0.44,p=0.38).Conclusions:Our results show that NLR and PLR values can predict the onset and prognosis of SSNHL.     

Optimal continuous positive airway pressure level in korean patients with obstructive sleep apnea syndrome

Objectives

The aim of this study was to investigate optimal continuous positive airway pressure (CPAP) level, to examine the factors affecting optimal CPAP level, and to develop a predictive equation for optimal CPAP level in Korean patients with obstructive sleep apnea syndrome (OSAS).

Methods

A total of 202 patients with OSAS who underwent successful manual titration for CPAP treatment were included in this study. Correlations between the optimal CPAP level and baseline data including anthropometric and polysomnographic variables were analyzed. A predictive equation for optimal CPAP level was developed based on anthropometric and polysomonographic data.

Results

The mean optimal CPAP level in 202 patients with OSAS was 7.8±2.3 cm H₂O. The mean optimal CPAP level in the mild, moderate, and severe OSAS groups was 6.0±1.3, 7.4±1.9, and 9.1±2.1 cm H₂O, respectively. The apneahypopnea index (AHI) (r=0.595, P<0.001), arousal index (r=0.542, P<0.001), minimal SaO₂ (r=-0.502, P<0.001), body mass index (BMI) (r=0.494, P<0.001), neck circumference (r=0.265, P<0.001), and age (r=-0.164, P=0.019) were significantly correlated with optimal CPAP level. The best predictive equation according to stepwise multiple linear regression analysis was: Optimal CPAP level (cm H₂O)=0.681+(0.205×BMI)+(0.040×AHI). Forty-two percent of the variance in the optimal CPAP level was explained by this equation (R²=0.42, P<0.001).

Conclusion

A predictive equation for optimal CPAP level in Korean patients with OSAS was developed using AHI and BMI, which can be easily measured during the diagnostic process.     

Functional Benefit after Modification of Radial Forearm Free Flap for Soft Palate Reconstruction

Objectives

To compare the velopharyngeal function, swallowing and speech of the conventional and modified radial forearm free flap (RFFF) for soft palate reconstruction.

Methods

Retrospective clinical study. Twenty-eight patients who underwent oropharyngeal reconstruction with RFFF were divided into two groups: 10 patients had conventional folded RFFF and 18 patients underwent modified method.

Results

The average speech intelligibility score in modified RFFF group was 8.0±2.4, and 6.2±2.2 in conventional RFFF group (P<0.05). The nasalance was 27.4±7.8% in modified group and 38.6±2.7% in conventional group during no nasal passage reading and 43.6±7.3% in modified group, 55.2±7.6% in conventional group during high nasal passage reading (P<0.05). The subjective swallowing functional score was 2.8 in modified group and 2.1 in conventional group.

Conclusion

The speech assessment and nasalance demonstrate a more favorable outcome in modified group than conventional group.     

Rapid Increase in Neural Conduction Time in the Adult Human Auditory Brainstem Following Sudden Unilateral Deafness

Individuals with sudden unilateral deafness offer a unique opportunity to study plasticity of the binaural auditory system in adult humans. Stimulation of the intact ear results in increased activity in the auditory cortex. However, there are no reports of changes at sub-cortical levels in humans. Therefore, the aim of the present study was to investigate changes in sub-cortical activity immediately before and after the onset of surgically induced unilateral deafness in adult humans. Click-evoked auditory brainstem responses (ABRs) to stimulation of the healthy ear were recorded from ten adults during the course of translabyrinthine surgery for the removal of a unilateral acoustic neuroma. This surgical technique always results in abrupt deafferentation of the affected ear. The results revealed a rapid (within minutes) reduction in latency of wave V (mean pre = 6.55 ms; mean post = 6.15 ms; p < 0.001). A latency reduction was also observed for wave III (mean pre = 4.40 ms; mean post = 4.13 ms; p < 0.001). These reductions in response latency are consistent with functional changes including disinhibition or/and more rapid intra-cellular signalling affecting binaurally sensitive neurons in the central auditory system. The results are highly relevant for improved understanding of putative physiological mechanisms underlying perceptual disorders such as tinnitus and hyperacusis.     

Gentamicin is Primarily Localized in Vestibular Type I Hair Cells after Intratympanic Administration

Intratympanic (IT) gentamicin injections are effective in the control of episodic vertigo due to Ménière’s disease. Histological studies in animals have found that the loss of type I vestibular hair cells far exceeds that of type II cells after IT gentamicin treatment. The objective of this study was to determine whether this selective toxicity for type I hair cells might be due to selective concentration of the drug by these cells. Gentamicin was localized within the vestibular epithelium by both direct and indirect methods. Gentamicin conjugated to Texas Red® was used as a direct tracer, and anti-gentamicin antibody provided an indirect means of localization. Conjugated or unconjugated gentamicin was injected into the left tympanic space of chinchillas. The animals were killed and fixed 1 or 3 weeks post-treatment. Confocal fluorescence microscopy was used to determine the localization of gentamicin in semicircular canal cristae. Results from the animals killed within 1 week of administration showed that numerous type I hair cells still remained throughout the epithelium. The mean intensity in grayscale units (0–255) of anti-gentamicin labeling for type I hair cells was 28.14 (95% CI 24.60–31.69), for type II hair cells was 17.09 (14.99–19.20), and for support cells was 5.35 (5.34–5.46; p < 0.001, ANOVA). Anti-gentamicin antibody labeling appeared in the majority of type I hair cells throughout their cytoplasm, but with greater intensity at the apex (p < 0.001). Intensity of fluorescence with Texas-Red conjugated gentamicin was 25.38 (22.83–27.94) in type I hair cells, 15.60 (14.73–16.48) in type II cells, and 12.62 (12.06–13.17) in support cells (p < 0.001, ANOVA). These results suggest that type I hair cells are more susceptible to gentamicin because they more avidly take up or retain the drug in the early period after administration.