Rapid and definitive diagnosis is critical to the prevention of the spread of endemic human pathogenic viruses. Detection of variant specific genes by reverse transcription polymerase chain reaction (RT-PCR) has become a routine diagnostic test for accurate subtyping of RNA viruses, such as influenza. In this paper, we demonstrate the use of a continuous-flow polydimethylsiloxane (PDMS) microfluidic RT-PCR chip and disposable electrical printed (DEP) chips for rapid amplification and sensing of new influenza (AH1pdm) virus of swine-origin. The RT-PCR chip consisted of four zones: RT reaction zone, initial denaturation zone, thermal cycle zone for PCR (2-step PCR) and pressurizing-channel zone for preventing air-bubble formation. In order to measure electrochemical signals, methylene blue (MB), an electro-active DNA intercalator, was added to the RT-PCR mixture. The RT-PCR was completed within 15 min which was the total flow-through time from the inlet to the outlet, and the reduction signals from amplifications could be detected quickly on the DEP chip. The MB reduction current on the DEP chip with the amplicon significantly reduced compared to non-amplified controls. This microfluidic platform for rapid RT-PCR and the DEP chip for quick electrochemical sensing are suitable for integration, and have the potential to be a portable system for diagnostic tests.
The objectives of the retrospective study, performed at a tertiary referral center, were to examine the prognostic factors predicting long-term outcomes of tympanoplasty for perforated chronic otitis media (COM) and to determine whether mastoidectomy can be avoided during tympanoplasty for perforated COM. Between 1987 and 2002, 213 patients with perforated COM underwent tympanoplasty by the same surgeon and were followed for more than 5 years. Postoperative hearing outcomes were considered successful, if the postoperative air-bone gap was within 20 dB. Closure of perforation by a single surgery was considered a successful graft. Long-term outcomes were analyzed using logistic regression analysis. Normal ossicular chain was the only factor that showed a significantly favorable relation to long-term hearing outcomes. There were no significant predictors of long-term successful graft outcomes. Mastoidectomy was not a significant factor predicting long-term outcomes. Our long-term outcomes showed that mastoidectomy can be an avoidable surgical procedure in tympanoplasty for perforated COM, even if the ear is infected.
Kaplan-Meier survival analysis should be used for calculating the recurrence rate of cholesteatoma. Although this analytic method further demonstrates that CWDT is a more reliable surgical method than ICWT/CWR in reducing cholesteatoma recurrence, clinical judgment should be exercised, and we continue to recommend that a flexible approach should be adopted in deciding whether to perform CWDT or ICWT/CWR for individual cases.
Vestibular neuritis (VN) rapidly damages unilateral vestibular periphery, inducing severe balance disorders. In most cases, such vestibular imbalance is gradually restored to within the normal level after clinical therapies. This successive clinical recovery occurs due to regeneration of vestibular periphery and/or accomplishment of central vestibular compensation. We experienced 36 patients with VN treated at our hospital, including cases in our previous preliminary report. To elucidate effects of steroid therapy both on the recovery of peripheral function and on the adaptation of central vestibular compensation, we examined caloric test and several questionnaires with two randomly divided groups, 18 steroid-treated and 18 nonsteroid-treated patients, over two years after the onset. These examinations revealed that steroid-treated patients had a tendency of better canal improvements (13/18, 72%) than nonsteroid-treated ones (10/18, 55.6%). However, there was no significant difference between these two groups. In cases with persistent canal paresis, steroid-treated patients (n = 5) reduced handicaps in their everyday life due to the dizziness induced by head and/or body movements and the disturbance of their mood, more effectively than those with nonsteroid therapy (n = 8). These findings suggest that steroid therapy with VN could be effective on not only vestibular periphery but central vestibular system, to restore the balance.
The hearing outcomes after ossiculoplasty showed significant deterioration on long-term follow-up. Innovative approaches to the management of cholesteatoma/atelectasis are necessary to improve and stabilize long-term hearing outcomes.
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