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Background The lack of an effective diagnostic tool for Carrion’s disease leads to misdiagnosis, wrong treatments and perpetuation of asymptomatic carriers living in endemic areas. Conventional PCR approaches have been reported as a diagnostic technique. However, the detection limit of these techniques is not clear as well as if its usefulness in low bacteriemia cases. The aim of this study was to evaluate the detection limit of 3 PCR approaches. Methodology/Principal Findings We determined the detection limit of 3 different PCR approaches: Bartonella-specific 16S rRNA, fla and its genes. We also evaluated the viability of dry blood spots to be used as a sample transport system. Our results show that 16S rRNA PCR is the approach with a lowest detection limit, 5 CFU/μL, and thus, the best diagnostic PCR tool studied. Dry blood spots diminish the sensitivity of the assay. Methodology/Principal Findings We determined the detection limit of 3 different PCR approaches: Bartonella-specific 16S rRNA, fla and its genes. We also evaluated the viability of dry blood spots to be used as a sample transport system. Our results show that 16S rRNA PCR is the approach with a lowest detection limit, 5 CFU/μL, and thus, the best diagnostic PCR tool studied. Dry blood spots diminish the sensitivity of the assay. Conclusions/Significance From the tested PCRs, the 16S rRNA PCR-approach is the best to be used in the direct blood detection of acute cases of Carrion’s disease. However its use in samples from dry blood spots results in easier management of transport samples in rural areas, a slight decrease in the sensitivity was observed. The usefulness to detect by PCR the presence of low-bacteriemic or asymptomatic carriers is doubtful, showing the need to search for new more sensible techniques.

In this study, the relationship between soil suction and shear strength parameters of compacted METU campus clay were investigated at different moisture contents. Soil samples were tested at optimum moisture content (i.e. w=20.8%), at dry side of optimum moisture content (i.e. w=14.8%, 16.8%, 18.8%) and at wet side of optimum moisture content (i.e. w=22.8%, 24.8%, 26.8%). Direct shear tests were performed to measure shear strength parameters (c&#039 / , &amp / #934 / &#039 / ) and soil suctions were measured by filter paper method after direct shear tests. These relationships were also investigated on soaked samples. The trends for suction, angle of internal friction and cohesion, which change on the dry side and wet side of optimum moisture content, were analyzed. The compacted METU campus clay gains granular soil fabric at the dry side of optimum moisture content. As moisture content increases, cohesion increases up to optimum moisture content and then decreases. But angle of internal friction decreases as moisture content increases. Soaking affects the samples more which are on the dry side of optimum moisture content. The soil suction (total suction and matric suction) affects the shear strength, and an increase in soil suction increases the shear strength.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / At present, the construction of highways in Andean areas the connect the various most important towns and cities in South America has become has become a key element for its development, since these routes and viaducts allow free access to cover basic needs of education, work, food and health of the population. Much of the land in these areas is clay soils whose behavior is quite unpredictable because they present abrupt volume changes according to the variation of saturation in the soil. People who travel on roads on slopes of this type of soil are at high risk due to the slippage that the slopes suffer each year. The most recent was on April 3, 2020 because of the heavy rainfall that was registered in the area; there was a landslide that affected communication channels in the department of Cajamarca in Peru [1]. In this type of slopes landslides occur when the clayey soil is specifically saturated, because under these conditions the soil is not stable and loses cohesion between its particles, therefore it is important to make slope stability studies taking into account the partially saturated soil. This article presents results of tests allow to recognize the physical characteristics of the clay soil in the province of Chepén in Cajamarca. In addition, the filter paper method is used to elaborate the soil-water characteristic curve and a series of direct shear tests are carried cut at different degrees of saturation. With these results, the partially saturate soil fault surface is constructed that allows visualizing the value of the shear stress of the soil according to the saturation to which it is subjected. This value will be important for calculating the safety factor that the slope floor must have of the resistance shear of the soil according to the saturation, this value will be important for the calculation of the safety factor that the floor of the slope must have so that it does not fall. Therefore, considering this condition of the partially saturated soil in the slope stability analysis provides values of the safety factor that are closer to reality, without the need to carry out the analysis in the most critical condition, such as what it done in classical soil mechanics.

A Doença de Gaucher (DG) é a Doença Lisossômica de Depósito mais frequente com prevalência de 1:50.000. Ela é causada pela deficiência da betaglicosidase ácida (GBA), gerando acúmulo de glicosilceramidas (glicocerebrosídio) nos lisossomos. Outra enzima relacionada é a quitotriosidase (QT), onde a atividade está aumentada nos pacientes em até 1000 vezes. Atualmente o diagnóstico é baseado na atividade específica de enzimas em leucócitos ou fibroblastos. O uso de sangue impregnado em papel filtro (SPF) vem sendo ampliado, porém somente como forma de triagem, pois não há forma validada de estabelecer a atividade específica da enzima. A utilização de sangue em papel filtro tem diversas vantagens, tais como: fácil transporte, fácil armazenagem das amostras, menor volume de reação e segurança de manipulação das amostras. Esse estudo tem como objetivo validar técnicas fluorimétricas para o estabelecimento da atividade específica da GBA e QT em sangue impregnado em papel filtro eluido com tampão universal (20 mmol/L de fosfato de sódio, pH 7,0) através da correção do volume amostral pela quantificação de proteínas totais. Além disso, foram miniaturizadas as técnicas padrão para a triagem em SPF e as técnicas confirmatórias padrão ouro em leucócitos da DG. Foram estabelecidos novos valores de referência para todas as técnicas estabelecidas. Foi possível diferenciar os controles saudáveis dos pacientes com DG utilizando as técnicas miniaturizadas em SPF e leucócitos. A atividade específica em SPF se mostrou valida e os coeficientes de variação foram considerados aceitáveis. A estabilidade enzimática foi analisada por 21 dias de armazenamento a 4°C e foi observado que a há um decaimento da atividade da GBA, mas não da QT. Deste modo a atividade específica em SPF pode ser utilizada de forma confiável como método de triagem e confirmação do diagnóstico de DG. / Gaucher disease (GD) is the most frequent Lysosomal Storage Disorder with a prevalence of 1:50,000. It is caused by the deficiency of acid betaglucosidase (GBA), generating glucosylceramide (glucocerebroside) accumulation in the lysosomes. Another enzyme related to GD is chitotriosidase (CT), which activity is increased in patients up to 1000 times. Currently the diagnosis is based on the specific activity of enzymes in leukocytes or fibroblasts. The use of dried blood spots (DBS) has been extended, but only as screening, because there is no validated specific activity of the enzymes. The use of DBS has several advantages, such as easy transport and easy storage of samples, smaller reaction volume and safety of handling samples. This study aims to validate fluorometric techniques for establishing specific activity of the GBA and CT in DBS eluted with universal buffer (20 mmol/L sodium phosphate, pH7.0) by correcting for sample volume quantification of total protein. Moreover, standard screening techniques in DBS and standard diagnosis techniques in leukocytes for GD have been miniaturized. New reference values and cut-off points were established for all techniques. It was possible to differentiate healthy controls from patients with GD using miniaturized techniques in DBS and leukocytes. The specific activity of DBS proved valid and coefficients of variation were acceptable. The enzymatic stability was analyzed by 21 days of storage at 4° C and it was observed that there is a decrease of the activity of GBA, but not of CT. Thus the specific activity on DBS can be used as a reliable screening method and as diagnosis of GD.

Submitted by Priscila Nascimento (pnascimento@icict.fiocruz.br) on 2012-12-03T16:23:50Z No. of bitstreams: 1 camille-brandao.pdf: 2860228 bytes, checksum: 83c9dbffefc606b192592b1683efd604 (MD5) / Made available in DSpace on 2012-12-03T16:23:50Z (GMT). No. of bitstreams: 1 camille-brandao.pdf: 2860228 bytes, checksum: 83c9dbffefc606b192592b1683efd604 (MD5) Previous issue date: 2011 / Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos. Rio de Janeiro, RJ, Brasil. / O presente estudo visa à adaptação de ensaios imunoenzimáticos comerciais de diagnóstico da hepatite C para uso em amostras de sangue coletado em papel de filtro (SCPF). Foram coletadas amostras pareadas de soro e SCPF de 411 indivíduos com média de idade de 40 anos, provenientes de banco de sangue e três unidades de saúde. As amostras foram submetidas a dois ensaios imunoenzimáticos (EIEs) para detecção de anticorpos anti-HCV: HCV Ab, Radim (Itália) e ETI-AB-HCVK-4, DiaSorin (Itália); e a dois EIEs para detecção simultânea de antígeno core do HCV e anticorpos anti-HCV, Monolisa TM HCV Ag-Ab ULTRA, Bio-Rad (França) e Murex HCV Ag/Ab Combination, Abbott (África do Sul). A detecção de anti-HCV e simultânea de antígeno e anticorpos anti-HCV em amostras de soro foi feita conforme recomendações dos fabricantes, e em SCPF foram avaliados os parâmetros, tampão de eluição, volumes de amostra, de diluente de amostra e de conjugado, tempo de incubação da amostra e valor do ponto de corte (PC). Após otimização desses parâmetros foram determinados os valores de sensibilidade (S), especificidade (E), concordância (valor de kappa), limite de detecção do teste, valores preditivos positivo (VPP) e negativo (VPN), precisão intraensaio e interensaio. A estabilidade das amostras de SCPF foi avaliada em diferentes condições ambientais (22-26ºC, 2-8°C e -20°C). Como resultado, o tampão PBS/BSA 0,5% foi selecionado para eluição das amostras de SCPF e estabelecido um aumento no volume de amostra para todos os fabricantes. Os tempos de incubação e os volumes de conjugado seguiram a recomendação dos fabricantes. Para o EIE HCV Ab os valores determinados foram S = 97,50%, E = 99,46%, kappa (k)= 0,959, VPP = 64,59% e VPN = 99,97%, para uma prevalência de doença de 1% na população. Para o EIE ETI-AB-HCVK-4, o PC foi estabelecido pela curva ROCe observou-se S = 88,89%, E = 98,89%, k= 0,875, VPP = 44,71% e VPN = 99,89%. O PC do EIE Monolisa TM HCV Ag-Ab ULTRA foi obtido pela curva ROCe verificou-se S = 95,12%, E =100%, k= 0,959, VPP = 100% e VPN = 99,95%. O PC para o EIE Murex HCV Ag/Ab Combinationfoi determinado pela média dos valores de densidade ótica (D.O.) das amostras de SCPF correspondentes àquelas de soro negativas no teste, acrescido de três desvios padrão proporcionando S = 78,05%, E = 99,43%, k= 0,838, VPP = 58,04% e VPN = 99,78%. O limite de detecção mostrou reatividade até a diluição de 1/10.000 para EIE HCV Ab e EIE ETI-AB-HCVK-4 e até 1/1.000 com EIE Monolisa TM HCV Ag-Ab ULTRA e EIE Murex HCV Ag/Ab Combination. Os resultados das amostras de SCPF obtiveram erro total inferior a 17% e as mesmas mantiveram-se estáveis nas diferentes condições de armazenamento por 60 dias. Os resultados obtidosnos EIE HCV ab e EIE Monolisa TM HCV Ag-Ab ULTRA mostraram-se mais concordantes com os observados com as amostras de soro, indicando melhor desempenho desses ensaios em amostras de SCPF. / The present study aims at adaptation of commercial enzyme immunoasssays for diagnosis of hepatitis C to be used with dried blood spots (DBS). Paired serum and DBS samples from 411 individuals with mean age of 40 years, were collected at Blood Center and three out patient units. Samples were tested for the detection of anti-HCV antibodies by using two enzyme immunoassays (EIAs): HCV Ab, Radim (Italy) and ETI-AB-HCVK-4, DiaSorin (Italy); and two EIAs for the simultaneous detection of hepatites C virus (HCV) core antigen and anti-HCV antibodies: Monolisa TM HCV Ag-Ab ULTRA, Bio-Rad (France) and Murex HCV Ag/Ab Combination, Abbott (South Africa). Anti-HCV detection and simultaneous detection of HCV core antigen and anti-HCV antibodies in serum sample were perfomed according to the manufacture’s recommendations. In DBS samples parameters such as elution buffer, sample, diluent, and conjugate volumes, incubation period, and cut off (CO) values were evaluated. After optimization of these parameters, values of sensitivity, specificity, inter-rater agreement (kappa value), detection limit, intra- and inter-assay precision were determinated. Stability of DBS samples was investigated in different conditions (22-26ºC, 2-8°C e -20°C). As results, PBS/BSA 0,5% buffer was chosen as elution buffer in DBS samples and an increased volume of the samples in all EIAs was established. Incubation duration and volume of conjugate were in accordance with manufacturer’s recommendations. With EIA HCV Ab values sensitivity of 97,50%, specificity 99,46%, inter-rate agreement 0,959, positive predictive value 64,59%, and negative predictive value (1% of disease prevalence) 99,97% were observed. For the EIA ETI-AB-HCVK-4 best cut-off values were obtained from ROC curve and observed values were sensitivity 88,89%, specificity 98,89%, inter-rate agreement 0,875, positive predictive value 44,71%, and negative predictive value 99,89%. For the EIA Monolisa TM HCV Ag-Ab ULTRA best cut-off values were obtained from ROC curve with sensitivity of 95,12%, specificity 100%, inter-rate agreement 0,959, positive predictive value 100%, and negative predictive value 99,95%. For the EIA Murex HCV Ag/Ab Combination best cut-off values were obtained by calculating the average of optical density of DBS samples correspondent to those with negative results in serum plus three standard deviations, resulting in a sensitivity of 78,05%, specificity of 99,43%, inter-rate agreement of 0,838, positive predictive value of 58,04%, and a negative predictive value of 99,78%. The lower limit of HCV Ab and ETI-AB-HCVK-4 tests in DBS was 1/10.000, and for Monolisa TM HCV Ag-Ab ULTRA and Murex HCV Ag/Ab Combination was 1/1.000. Total error of DBS results was below 17% and all DBS samples maintained stable in all storage conditions for 60 days. Results obtained with EIE HCV Ab and EIA Monolisa TM HCV Ag-Ab ULTRA were found to be more concordant with those observed for serum samples, indicating a better performance of theses assays inDBS samples.

A Doença de Gaucher (DG) é a Doença Lisossômica de Depósito mais frequente com prevalência de 1:50.000. Ela é causada pela deficiência da betaglicosidase ácida (GBA), gerando acúmulo de glicosilceramidas (glicocerebrosídio) nos lisossomos. Outra enzima relacionada é a quitotriosidase (QT), onde a atividade está aumentada nos pacientes em até 1000 vezes. Atualmente o diagnóstico é baseado na atividade específica de enzimas em leucócitos ou fibroblastos. O uso de sangue impregnado em papel filtro (SPF) vem sendo ampliado, porém somente como forma de triagem, pois não há forma validada de estabelecer a atividade específica da enzima. A utilização de sangue em papel filtro tem diversas vantagens, tais como: fácil transporte, fácil armazenagem das amostras, menor volume de reação e segurança de manipulação das amostras. Esse estudo tem como objetivo validar técnicas fluorimétricas para o estabelecimento da atividade específica da GBA e QT em sangue impregnado em papel filtro eluido com tampão universal (20 mmol/L de fosfato de sódio, pH 7,0) através da correção do volume amostral pela quantificação de proteínas totais. Além disso, foram miniaturizadas as técnicas padrão para a triagem em SPF e as técnicas confirmatórias padrão ouro em leucócitos da DG. Foram estabelecidos novos valores de referência para todas as técnicas estabelecidas. Foi possível diferenciar os controles saudáveis dos pacientes com DG utilizando as técnicas miniaturizadas em SPF e leucócitos. A atividade específica em SPF se mostrou valida e os coeficientes de variação foram considerados aceitáveis. A estabilidade enzimática foi analisada por 21 dias de armazenamento a 4°C e foi observado que a há um decaimento da atividade da GBA, mas não da QT. Deste modo a atividade específica em SPF pode ser utilizada de forma confiável como método de triagem e confirmação do diagnóstico de DG. / Gaucher disease (GD) is the most frequent Lysosomal Storage Disorder with a prevalence of 1:50,000. It is caused by the deficiency of acid betaglucosidase (GBA), generating glucosylceramide (glucocerebroside) accumulation in the lysosomes. Another enzyme related to GD is chitotriosidase (CT), which activity is increased in patients up to 1000 times. Currently the diagnosis is based on the specific activity of enzymes in leukocytes or fibroblasts. The use of dried blood spots (DBS) has been extended, but only as screening, because there is no validated specific activity of the enzymes. The use of DBS has several advantages, such as easy transport and easy storage of samples, smaller reaction volume and safety of handling samples. This study aims to validate fluorometric techniques for establishing specific activity of the GBA and CT in DBS eluted with universal buffer (20 mmol/L sodium phosphate, pH7.0) by correcting for sample volume quantification of total protein. Moreover, standard screening techniques in DBS and standard diagnosis techniques in leukocytes for GD have been miniaturized. New reference values and cut-off points were established for all techniques. It was possible to differentiate healthy controls from patients with GD using miniaturized techniques in DBS and leukocytes. The specific activity of DBS proved valid and coefficients of variation were acceptable. The enzymatic stability was analyzed by 21 days of storage at 4° C and it was observed that there is a decrease of the activity of GBA, but not of CT. Thus the specific activity on DBS can be used as a reliable screening method and as diagnosis of GD.

A Doença de Gaucher (DG) é a Doença Lisossômica de Depósito mais frequente com prevalência de 1:50.000. Ela é causada pela deficiência da betaglicosidase ácida (GBA), gerando acúmulo de glicosilceramidas (glicocerebrosídio) nos lisossomos. Outra enzima relacionada é a quitotriosidase (QT), onde a atividade está aumentada nos pacientes em até 1000 vezes. Atualmente o diagnóstico é baseado na atividade específica de enzimas em leucócitos ou fibroblastos. O uso de sangue impregnado em papel filtro (SPF) vem sendo ampliado, porém somente como forma de triagem, pois não há forma validada de estabelecer a atividade específica da enzima. A utilização de sangue em papel filtro tem diversas vantagens, tais como: fácil transporte, fácil armazenagem das amostras, menor volume de reação e segurança de manipulação das amostras. Esse estudo tem como objetivo validar técnicas fluorimétricas para o estabelecimento da atividade específica da GBA e QT em sangue impregnado em papel filtro eluido com tampão universal (20 mmol/L de fosfato de sódio, pH 7,0) através da correção do volume amostral pela quantificação de proteínas totais. Além disso, foram miniaturizadas as técnicas padrão para a triagem em SPF e as técnicas confirmatórias padrão ouro em leucócitos da DG. Foram estabelecidos novos valores de referência para todas as técnicas estabelecidas. Foi possível diferenciar os controles saudáveis dos pacientes com DG utilizando as técnicas miniaturizadas em SPF e leucócitos. A atividade específica em SPF se mostrou valida e os coeficientes de variação foram considerados aceitáveis. A estabilidade enzimática foi analisada por 21 dias de armazenamento a 4°C e foi observado que a há um decaimento da atividade da GBA, mas não da QT. Deste modo a atividade específica em SPF pode ser utilizada de forma confiável como método de triagem e confirmação do diagnóstico de DG. / Gaucher disease (GD) is the most frequent Lysosomal Storage Disorder with a prevalence of 1:50,000. It is caused by the deficiency of acid betaglucosidase (GBA), generating glucosylceramide (glucocerebroside) accumulation in the lysosomes. Another enzyme related to GD is chitotriosidase (CT), which activity is increased in patients up to 1000 times. Currently the diagnosis is based on the specific activity of enzymes in leukocytes or fibroblasts. The use of dried blood spots (DBS) has been extended, but only as screening, because there is no validated specific activity of the enzymes. The use of DBS has several advantages, such as easy transport and easy storage of samples, smaller reaction volume and safety of handling samples. This study aims to validate fluorometric techniques for establishing specific activity of the GBA and CT in DBS eluted with universal buffer (20 mmol/L sodium phosphate, pH7.0) by correcting for sample volume quantification of total protein. Moreover, standard screening techniques in DBS and standard diagnosis techniques in leukocytes for GD have been miniaturized. New reference values and cut-off points were established for all techniques. It was possible to differentiate healthy controls from patients with GD using miniaturized techniques in DBS and leukocytes. The specific activity of DBS proved valid and coefficients of variation were acceptable. The enzymatic stability was analyzed by 21 days of storage at 4° C and it was observed that there is a decrease of the activity of GBA, but not of CT. Thus the specific activity on DBS can be used as a reliable screening method and as diagnosis of GD.

Orientador: Miriam Gonçalves Miguel / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e Urbanismo / Made available in DSpace on 2018-08-11T22:58:54Z (GMT). No. of bitstreams: 1 Bonder_BrunnoHenrique_M.pdf: 2047878 bytes, checksum: f980b746a4148ebf1cf393fb9e4a010a (MD5) Previous issue date: 2008 / Resumo: Como ponto de partida, concentra-se esta pesquisa em determinar as relações de teor de umidade (ou grau de saturação) versus o valor da sucção matricial, conhecidas por curvas características de sucção ou curvas de retenção, para o solo da camada superficial do Campo Experimental de Mecânica dos Solos e Fundações da UNICAMP. Esta camada é constituída de uma argila siltoarenosa, porosa, em condição não saturada, laterítica, colapsível e coluvionar de espessura em torno de 6,5m; resultante do alto grau de intemperismo. Na determinação das curvas utilizou-se a técnica do papel filtro, complementando a técnica de translação de eixos, já utilizada para o solo, através do Aparelho de Richards. Os procedimentos foram de secagem e de umedecimento das amostras, permitindo o estudo do fenômeno de histerese, à luz da estrutura e da composição químico-mineralógica do solo. Também foi realizado um monitoramento em campo da variação da sucção matricial ao longo de um ano, para confirmar o fenômeno da histerese que ocorre in situo As curvas de retenção de água forneceram valores de pressão de entrada de ar que variam de 1 à 5 kPa, dependendo da técnica utilizada, lembrando o comportamento de areias, e mostraram que o fenômeno da histerese ocorre de maneira mais acentuada, em solos com poros maiores. Confrontaram-se os resultados obtidos com as diferentes técnicas de realização dos ensaios e analisaram-se as diferenças entre elas. / Abstract: This research focuses in to determine the relationship of moisture content (or degree of saturation) versus the value of the suction matrix, known as soil water characteristic curve (SWCC), to the soil surface layer of the Field Experimental of Soil Mechanics and Foundation of UNICAMP. This profile consists of colluvial, lateritic, porous, on condition unsaturated and collapsible silty clay, with thickness around 6,5m and present on a clayed silt soil, residual of diabase; resulting from the high degree of weathering. To determine the curves, the techniques of filter paper and axis-translation were used, with a Richards equipment, this already used to the soil. The procedures were wetting and drying of the samples, allowing the study of the phenomenon of hysteresis, in the light of the structure and chemical and mineralogical composition of the soil. It was carried out in the field of "tracking a variation of suction matrix over a year, to confirm the phenomenon of hysteresis that occurs in situo The SWCCs supplied values of enter air ranging from 1 to 5 kPa, depending on the technique used, reminding the behaviour of sand, and showed that the phenomenon of hysteresis occurs in a manner more pronounced in soils with pores greater.' Compared the achievements of ,lhe different techniques for conducting the tests and analyzed the differences between them. / Mestrado / Geotecnia / Mestre em Engenharia Civil

The chorda tympani nerve, also known as the taste nerve, runs uncovered through the middle ear cavity, a localization that exposes the nerve to pathological processes and surgical trauma in the middle ear. People operated on for otosclerosis tend to complain more about postoperative taste disturbances than those operated on for chronic otitis media. It has been suggested that this difference may be explained by gradual deterioration of chorda tympani nerve function caused by chronic otitis media infection and that further impairment caused by surgery is less noticeable in these patients. This thesis aimed to evaluate the function of the chorda tympani nerve, the effects of middle ear disease on taste and complications resulting from ear surgery for chronic otitis media or otosclerosis. This information will help to improve the ear surgeon’s ability to predict the prognosis of iatrogenic taste disturbances in patients with middle ear disease and after ear surgery. Taste was assessed using electrogustometry and the filter paper disc method before and after surgery for chronic otitis media or otosclerosis. Patients also completed questionnaires about symptoms and quality of life. The status of the chorda tympani nerve upon surgical opening of the ear and grading of the trauma to the nerve during the surgery were recorded. The ultrastructure of the chorda tympani nerve from healthy ears and from ears with chronic otitis media was examined. Electrogustometry and the filter paper disc method were evaluated. The results of electrogustometry and the filter paper disc method were highly reproducible, although their correlation was moderate. Patients with chronic otitis media, patients with a more traumatized nerve, female patients and younger patients were more likely to report postoperative taste disturbances. Most of the patients recovered their taste after 1 year. The quality of life study showed only minor changes after surgery. Electron microscopic observations of nerves from ears with chronic otitis media showed signs of structural degeneration, although signs of regeneration, such as sprouting were also observed. This results may explain the recovery of taste postoperatively and indicate that the nerve should be carefully handled during surgery.