Objectives: . The aim of this study was to investigate whether preserved vestibular function in the high-frequency range influences the prognosis of patients with bilateral vestibulopathy (BVP) after vestibular rehabilitation. Methods: . Twenty-four patients followed up with vestibular rehabilitation were recruited. The enrolled patients were divided into two groups according to the preservation of the high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results of computerized dynamic posturography and the Dizziness Handicap Inventory (DHI) survey collected at baseline and at the 6-month follow-up after vestibular rehabilitation therapy were analyzed. Results: . Both groups showed significantly increased composite and DHI scores after follow-up with vestibular rehabilitation. The group with preserved high-frequency VOR showed a better composite score (p=0.064) and vestibular score (p= 0.008) than the group with lost high-frequency VOR at the 6-month follow up. The DHI score significantly decreased only in the group with lost high-frequency VOR (p=0.047). Among the three vestibular function tests (caloric test, rotary chair test, and vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p=0.015) with a favorable prognosis (composite score ≥70). Conclusion . Better treatment outcomes are likely in patients with BVP with preserved vestibular function in response to high-frequency stimulation, as measured by the vHIT.

Background and Objectives: This study aimed to compare subjective satisfaction and functional hearing gain between users of hearing aids with insurance payment (HA with IP) and hearing aids with general payment (HA with GP).Subjects and Method The functional hearing gain and subjective satisfaction of 42 HA with IP and 38 HA with GP were compared after the final fitting, retrospectively. Sound field pure tone and speech audiometry were performed after 4 sessions of hearing aids fitting. Subjective satisfaction was evaluated using the Korean version of abbreviated profile of hearing aid benefit (APHAB) and the international outcome inventory for hearing aids (IOI-HA). Results: Sound field pure tone thresholds and speech discrimination scores were improved after the final fitting of hearing aids in both HA with IP and HA with GP groups. HA with IP group showed significantly better results in aversiveness of APHAB and the IOI-HA scores than HA with GP group did. Conclusion These results suggest that hearing aids with insurance payment provide considerable benefits and satisfaction, and can be a good alternative for hearing rehabilitation in hearing-impaired patients.

Objectives: . The aim of this study was to investigate whether preserved vestibular function in the high-frequency range influences the prognosis of patients with bilateral vestibulopathy (BVP) after vestibular rehabilitation. Methods: . Twenty-four patients followed up with vestibular rehabilitation were recruited. The enrolled patients were divided into two groups according to the preservation of the high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results of computerized dynamic posturography and the Dizziness Handicap Inventory (DHI) survey collected at baseline and at the 6-month follow-up after vestibular rehabilitation therapy were analyzed. Results: . Both groups showed significantly increased composite and DHI scores after follow-up with vestibular rehabilitation. The group with preserved high-frequency VOR showed a better composite score (p=0.064) and vestibular score (p= 0.008) than the group with lost high-frequency VOR at the 6-month follow up. The DHI score significantly decreased only in the group with lost high-frequency VOR (p=0.047). Among the three vestibular function tests (caloric test, rotary chair test, and vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p=0.015) with a favorable prognosis (composite score ≥70). Conclusion . Better treatment outcomes are likely in patients with BVP with preserved vestibular function in response to high-frequency stimulation, as measured by the vHIT.

No abstract available.
Down Syndrome*

There have been no reports indicating diurnal variations in MRI at different portions of each lumbar disc. Eight asymptomatic healthy volunteers between 22 and 29 years old had MRI of their lumbar spine, twice on the same day (in the morning and evening). Forty lumbar discs were studied and the signal intensity change was measured from three portions of each disc (a total of 120 portions). No visible changes could be detected between scans by blinded observers. However, the calculated signal intensity changes showed an average loss of -20.0% (ant., 5 cases), -19.0% (mid, 2 cases), and -17.5% (post., 1 case). Height loss of the disc showed an average loss of -9.9% (ant., 4 cases), -8.3% (mid., 2 cases), and -10.4% (post., 2 cases). An increase of disc bulge at L4-5 level (18.3%) was pronounced, but L5-S1 level was less than others. Loss of body height averaged a loss of 7 mm (0.39% of body height). There was no correlation between reduced signal intensity and height loss at the ant./post. portion (p = 0.42), but there was a close relation at the mid. portion (p = 0.008). Diurnal change of the disc bulge was not correlated with reduced signal intensity (p = 0.48) or height loss (p = 0.16). Intradiscal fluid change was not necessarily influenced by the disc height loss, and height loss did not necessarily have an effect on disc bulge. But diurnal change showed a trend that was reflected in reduced signal intensity, height loss, and an increase of disc bulge which was more apparent from the ant. portion to the post, portion on moving down to the lower levels. Loss of disc height was one factor in the reduction of body height. These changes occurred randomly throughout 5 lumbar disc levels in each case.
Adult ; Circadian Rhythm* ; Female ; Human ; Intervertebral Disk/anatomy & histology ; Lumbar Vertebrae/pathology* ; Magnetic Resonance Imaging* ; Male

OBJECTIVES: Carcinomas of the external auditory canal (EAC) are rare, and management remains challenging. Previous studies seeking prognostic factors for EAC cancers included cancers other than carcinomas. In this study, we analyzed the treatment outcomes of, prognostic factors for, and survival rates associated with specifically squamous cell carcinoma (SCC) of the EAC. METHODS: A retrospective review of 26 consecutive patients diagnosed with SCCs of the EAC in a 10-year period was performed in terms of clinical presentation, stage, choice of surgical procedure, and adjunct therapy. Overall survival (OS) and recurrence-free survival (RFS) were calculated and univariate analysis of prognostic factors was performed. RESULTS: The median age of the 26 patients with SCCs of the EAC was 63 years (range, 40 to 72 years), and 16 males and 10 females were included. According to the modified University of Pittsburgh staging system, the T stages were T1 in 11, T2 in six, T3 in four, and T4 in five cases. The surgical procedures employed were wide excision in three cases, lateral temporal bone resection (LTBR) in 17, and extended LTBR in four, and subtotal temporal bone resection in two. Two patients underwent neoadjuvant chemotherapy, and two underwent adjuvant chemotherapy. One patient received preoperative radiation therapy, and eleven received postoperative radiation therapy. Of the possibly prognostic factors examined, advanced preoperative T stage and advanced overall stage were significant predictors of RFS, but not of OS. CONCLUSION: The advanced T stage and overall stage were associated with decreased survival after surgical treatment in patients with SCC of the EAC, highlighting the importance of clinical vigilance and early detection.
Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Drug Therapy ; Ear Canal* ; Ear Neoplasms ; Epithelial Cells* ; Female ; Humans ; Male ; Retrospective Studies ; Survival Rate ; Temporal Bone

OBJECTIVES: The prognosis of sudden low frequency hearing loss (SLFHL) is relatively good, but recurrences of hearing loss and possible progression to Meniere's disease is still a clinically important concern. This study was conducted to confirm the rate at which SLFHL proceeds to Meniere's disease. METHODS: We retrospectively analyzed the medical records of 160 SLFHL patients who were followed up for more than 6 months from September 2005 to August 2013. Progression, initial hearing level, recovery and recurrence of hearing loss were reviewed. RESULTS: 106 patients (66.25%) had complete hearing recovery, 32 (20%) had recurrent hearing loss. Of the 32 recurrent group, 15 (9.38%) had progressed to Meniere's disease after average of 1.7±1.4 years. The mean age of nonrecurrent group was higher than recurrent group (55.3±14.6 and 48.0±13.4, respectively, p=0.011). The threshold of 250Hz was significantly higher in the nonrecurrent group compared with recurrent group (p=0.047). CONCLUSIONS: In patients with SLFHL, recurrence at relatively young age should be considered with the possibility of progression to Meniere's disease.
Follow-Up Studies ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Hearing ; Humans ; Medical Records ; Meniere Disease ; Prognosis ; Recurrence ; Retrospective Studies

A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.
Anesthesia, General ; Cochlear Implants ; Coronary Angiography ; Diagnosis ; Electrocardiography ; Female ; Head ; Humans ; Middle Aged ; Neck ; Nitroglycerin ; Recurrence ; Thorax

BACKGROUND AND OBJECTIVES: Components of extracellular matrix protein play a crucial role in morphogenesis and epithelial cell differentiation. Protein is highly conserved during evolution and is expressed in a variety of tissues, and the amount of T and B lymphocytes are significantly higher in cholesteatomatous tissue than in the external auditory canal skin. We examined the spatiotemporal expression and distribution of extracelluar matrix protein tenascin and lymphocytes of cholesteatomatous tissue and normal external auditory canal skin. MATERIAL AND METHODS: The biopsy specimens of cholesteatomatous tissue and external auditory canal skin were obtained during middle ear surgery. Monoclonal mouse antibodies against tenascin, CD4 helper cell and CD8 cytotoxic/suppressor T cells were used. RESULTS: The results are as follows: 1) The expression of tenascin was significantly increased in cholesteatomatous tissue compared to that in normal external auditory canal skin. 2) As the expression of T lymphocytes increased, the expression of tenascin increased significantly (p<0.05, r=0.832). 3) As the expression of Langerhans' cells increased, the expression of tenascin increased significantly (p<0.05, r=0.788). CONCLUSION: These results suggest that the change in the composition of the extracelluar matrix protein and lymphocyte in cholesteatomatous tissue may play an important role in the pathogenesis of cholesteatomatous otitis media.
Animals ; Antibodies ; B-Lymphocytes ; Biopsy ; Cholesteatoma* ; Ear Canal ; Ear, Middle ; Epithelial Cells ; Extracellular Matrix* ; Lymphocytes ; Mice ; Morphogenesis ; Otitis Media ; Skin ; T-Lymphocytes* ; T-Lymphocytes, Helper-Inducer ; Tenascin*

A large symptomatic and unresolved pancreatic pseudocyst is treated surgically by internal drainage to a neighboring adherent viscus. Recently the various minimal invasive approaches have been used to treat this condition. A 30- year-old man who had been in clinical follow-up for a chronic pancreatitis. For the necrotizing pancreatitis, the patient had undergone surgical debridement and external drainage 5 years, and 3 years ago, respectively. Abdominal ultrasonography and computed tomography revealed 8.2x7.7 cm sized pseudocyst in the body of pancreas. Endoscopic internal fistula formation was tried, but it was failed due to bleeding. We underwent adhesiotomy and cystogastrostomy totally with laparoscopic techniques. The patient started a diet on the 5th postoperative day and discharged on the 11th postoperative day. There was no postoperative complicationand no recurrence during 6 months. Laparoscopic cystogastrostomy is safe and feasible method in the pancreatic pseudocyst even in case of severe abdominal adhesion.
Debridement ; Diet ; Drainage ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Pancreas ; Pancreatic Pseudocyst* ; Pancreatitis ; Pancreatitis, Chronic ; Recurrence ; Ultrasonography