OBJECTIVES: To evaluate that the cross-sectional area of the air space in the Eustachian tube (ET) on computed tomography (CT) images could be useful for predicting the postoperative aeration of the middle ear. METHODS: The patient group consisted of 80 patients (80 ears) with chronic otitis media and who underwent middle ear surgery from 2006-2007 and who were followed up for more than 1 yr. The control group consisted of 100 ears of 50 individuals with normal tympanic membranes and who underwent CT for other causes (such as tinnitus or hearing loss). The largest cross-sectional areas of the aerated ET were measured on the coronal images of the temporal bone CT by a single otologist using the computer-based "Region of Interest" picture archiving and communications system. The patient group was divided into two subgroups, 1) those with good postoperative aeration and 2) those with poor postoperative aeration. The largest cross-sectional areas of the aerated ETs were compared between the patients and the controls, and between the patients with good aeration and the patients with poor aeration. RESULTS: The mean cross-sectional areas significantly differed between the patient group and the control group, and between the good and poor aeration subgroups (P<0.05 each). The mean area of the poor aeration subgroup was smaller than that of the control group (P<0.05), but the mean area of the good aeration subgroup did not significantly differ from that of the controls. CONCLUSION: The cross-sectional area of the aerated ET, as measured on the preoperative coronal images of temporal bone CT scans, may be useful for predicting the postoperative condition of the tympanic cavity.
Ear ; Ear, Middle ; Eustachian Tube ; Hearing ; Humans ; Otitis ; Otitis Media ; Temporal Bone ; Tinnitus ; Tympanic Membrane

Steroid myopathy is one of the most common drug-induced myopathy. We report a case of iatrogenic steroid myopathy in a 61-year-old female who had taken herb medication more than 2 months. She presented a slowly progressive proximal muscle weakness and wasting with typical features of cushing syndrome. Needle EMG showed typical myopathic patterns. The muscle biopsy revealed a pronounced muscle fiber atrophy and fatty degenerative change without inflammation. In addition, there was a selective type 2 fiber depletion on ATPase staining in pH 9.4 buffer. Her muscle powers and bulks were slowly improved after discontinuation of herb medication with phenytoin and physical therapy.
Adenosine Triphosphatases ; Atrophy ; Biopsy ; Cushing Syndrome* ; Female ; Humans ; Hydrogen-Ion Concentration ; Inflammation ; Middle Aged ; Muscle Weakness ; Muscular Diseases* ; Needles ; Phenytoin

BACKGROUND AND OBJECTIVES: Postnasal drip is a common presentation to the medical practitioner. It is a result of disturbance to the normal drainage or an increase in secretion of the paranasal sinuses. However, sometimes no underlying cause can be found and the patient has to be reassured, and that they may just have to live with it. The aim of this study is to evaluate the clinical manifestations of patients with postnasal drip. MATERIAL AND METHOD: There were 90 patients complaining with postnasal drip. We performed a prospective study about accompanying symptoms and physical and psychiatric evaluation. CONCLUSION: Postnasal drip is more common in females over 30 years and the duration of symptoms is usually long. Anatomical nasal abnormality and sinusitis are common. There is no correlation with postnasal drip and psychiatric problems. But several items are concerned with postnasal drip. So we need detailed history taking and physical examination on patients who complained of postnasal drip.
Drainage ; Female ; Humans ; Paranasal Sinuses ; Physical Examination ; Prospective Studies ; Sinusitis

BACKGROUND AND OBJECTIVES: Food restriction retards aging and increases mean and maximum life span in nearly all species tested thus far. Calcium-binding proteins show a heterogenous distribution in the mammalian central nervous system and are useful markers for identifying neuronal populations. These proteins have been implicated in the buffering and transport of calcium as well as in the regulation of various enzyme systems. We investigated the change of the immunoreactivity of calcium-binding proteins in olfactory bulb of rat after food restriction. MATERIALS AND METHOD: 10 weeks old Sprague-Dawley rat were used in this study. 6 rats were killed at the beginning of the experiment. 30 rats which were restricted food only half of their normal voluntary mean food intake (12 g instead of 24 g per day) were killed at 3 days, 1, 2, 4 and 9 weeks after food restriction (n=6 per time point). Olfactory bulbs of the rats were cut into 40 micro m-thick coronal sections and immunostained. RESULTS: On the layers of olfactory nerve, glomerular, outer plexiform, granular cell and subependymal zone, immunoreactivities of parvalbumin and calbindin were increased on food restriction week 1 and 2. However, parvalbumin at olfactory nerve layer and calbindin at granule cell layer failed to increase at week 2. Calretinin increased its immunoreactivity at olfactory nerve and outer plexiform layer at week 1. After restriction week 2, immunoreactivity of calcium-binding proteins was almost same as control. CONCLUSION: The results we obtained from restricted rats indicated that parvalbumin, calbindin and calretinin could be expressed by different manner and layer in olfactory bulb.
Aging ; Animals ; Calbindin 2 ; Calbindins ; Calcium* ; Calcium-Binding Proteins* ; Central Nervous System ; Eating ; Neurons ; Olfactory Bulb* ; Olfactory Nerve ; Rats* ; Rats, Sprague-Dawley

What is memory? How does the brain process the sensory information and modify an organism's behavior? Many neuroscientists have focused on the activity- and experience-dependent modifications of synaptic functions in order to solve these fundamental questions in neuroscience. Recently, the plasticity of intrinsic excitability (called intrinsic plasticity) has emerged as an important element for information processing and storage in the brain. As the cerebellar Purkinje cells are the sole output neurons in the cerebellar cortex and the information is conveyed from a neuron to its relay neurons by forms of action potential firing, the modulation of the intrinsic firing activity may play a critical role in the cerebellar learning. Many voltage-gated and/or Ca²⁺-activated ion channels are involved in shaping the spiking output as well as integrating synaptic inputs to finely tune the cerebellar output. Recent studies suggested that the modulation of the intrinsic excitability and its plasticity in the cerebellar Purkinje cells might function as an integrator for information processing and memory formation. Moreover, the intrinsic plasticity might also determine the strength of connectivity to the sub-cortical areas such as deep cerebellar nuclei and vestibular nuclei to trigger the consolidation of the cerebellar-dependent memory by transferring the information.
Action Potentials ; Automatic Data Processing ; Brain ; Cerebellar Cortex ; Cerebellar Nuclei ; Cerebellum ; Fires ; Ion Channels ; Learning* ; Memory ; Neuronal Plasticity ; Neurons ; Neurosciences ; Plastics* ; Purkinje Cells* ; Vestibular Nuclei

The superficial dorsal horn of the spinal cord plays an important role in pain transmission and opioid activity. Several studies have demonstrated that opioids modulate pain transmission, and the activation of µ-opioid receptors (MORs) by opioids contributes to analgesic effects in the spinal cord. However, the effect of the activation of MORs on GABAergic interneurons and the contribution to the analgesic effect are much less clear. In this study, using transgenic mice, which allow the identification of GABAergic interneurons, we investigated how the activation of MORs affects the excitability of GABAergic interneurons and synaptic transmission between primary nociceptive afferent and GABAergic interneurons. We found that a selective µ-opioid agonist, [D-Ala², NMe-Phe⁴, Gly-ol]-enkephanlin (DAMGO), induced an outward current mediated by K⁺ channels in GABAergic interneurons. In addition, DAMGO reduced the amplitude of evoked excitatory postsynaptic currents (EPSCs) of GABAergic interneurons which receive monosynaptic inputs from primary nociceptive C fibers. Taken together, we found that DAMGO reduced the excitability of GABAergic interneurons and synaptic transmission between primary nociceptive C fibers and GABAergic interneurons. These results suggest one possibility that suppression of GABAergic interneurons by DMAGO may reduce the inhibition on secondary GABAergic interneurons, which increase the inhibition of the secondary GABAergic interneurons to excitatory neurons in the spinal dorsal horn. In this circumstance, the sum of excitation of the entire spinal network will control the pain transmission.
Analgesics, Opioid ; Animals ; Enkephalin, Ala(2)-MePhe(4)-Gly(5)- ; Excitatory Postsynaptic Potentials ; GABAergic Neurons* ; Interneurons ; Mice ; Mice, Transgenic ; Nerve Fibers, Unmyelinated ; Neurons ; Spinal Cord ; Spinal Cord Dorsal Horn* ; Substantia Gelatinosa ; Synaptic Transmission

Background: South Korea has one of the world’s fastest aging populations and is witnessing increased age-related hearing impairment cases as well as an increase in the number of hearing aid users. The aim of this study was to analyze complications caused by hearing aid mold materials. In addition, we hope to raise awareness of the harm and danger that inexperienced hearing aid providers can cause to patients. Methods: We retrospectively reviewed the medical records of 11 patients who were diagnosed with hearing aid mold material as a foreign body in the ear at a tertiary center between 2016 and 2020. The following data were analyzed: symptoms, endoscopic findings, audiometry, temporal bone CT images, treatment methods, and complications after removal. The currently available literature was also reviewed to develop clinical guidelines, to identify the systematic weaknesses in the South Korean hearing aid market, and to identify policies that warrant better quality control. Results: Among the 11 cases, 9 were restricted to the external auditory canal, all of which were successfully removed under endoscopy with minor complications. Two cases with middle ear involvement resulted in infection and thus required surgical removal with mastoidectomy. The average age of these patients was 76.4, and all patients received their molding procedure at private hearing aid shops without an otolaryngologist’s examination. Conclusion Thorough patient history-taking and otologic examination must be performed to identify patients at higher risk of complications. Such patients should be referred to an otolaryngologist. If a patient exhibits alarming symptoms, early referral is critical since prompt surgery can minimize complications. A CT scan is highly recommended to determine an optimal approach for foreign body removal. Systematic and regulatory changes in hearing aid dispensers, such as requiring apprenticeship, raising the required level of education, and legally mandating referrals, can help reduce these complications.

Hepatocellular carcinoma (HCC) presents a substantial public health challenge in South Korea as evidenced by 10,565 new cases annually (incidence rate of 30 per 100,000 individuals), in 2020. Cancer registries play a crucial role in gathering data on incidence, disease attributes, etiology, treatment modalities, outcomes, and informing health policies. The effectiveness of a registry depends on the completeness and accuracy of data. Established in 1999 by the Ministry of Health and Welfare, the Korea Central Cancer Registry (KCCR) is a comprehensive, legally mandated, nationwide registry that captures nearly all incidence and survival data for major cancers, including HCC, in Korea. However, detailed information on cancer staging, specific characteristics, and treatments is lacking. To address this gap, the KCCR, in partnership with the Korean Liver Cancer Association (KLCA), has implemented a systematic approach to collect detailed data on HCC since 2010. This involved random sampling of 10-15% of all new HCC cases diagnosed since 2003. The registry process encompassed four stages: random case selection, meticulous data extraction by trained personnel, expert validation, anonymization of personal data, and data dissemination for research purposes. This random sampling strategy mitigates the biases associated with voluntary reporting and aligns with stringent privacy regulations. This innovative approach positions the KCCR and KLCA as foundations for advancing cancer control and shaping health policies in South Korea.

Acute changes of the bilateral basal ganglia shown in the brain MRI a diabetic uremic patient have been rarely reported. We report a 52-year-old diabetic uremic patient who had neurological disturbances. At admission, axial diffusion-weighted images and T2-weighted images showed high signal intensities in the bilateral basal ganglia, and axial T1-weighted images visualized low signal intensities in same area. The underlying mechanism may be associated with metabolic as well as vascular factors.
Basal Ganglia* ; Brain ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Uremia

OBJECTIVES: To compare tinnitus patients who have normal hearing between 250 Hz and 8 kHz with normal controls with regard to the ability of each group to hear extended high-frequency pure tone thresholds. METHODS: We enrolled 18 tinnitus patients, each of whom had a threshold of HL <25 dB and threshold differences of <10 dB between ears at frequencies of 250 and 500 Hz and 1, 2, 4, and 8 kHz. We also enrolled age- and gender-matched normal volunteers (10 ears), for each patient. Extended high frequency pure tone audiometry was performed, and the mean hearing thresholds at 10, 12, 14, and 16 kHz of each tinnitus ear were compared with those of the 10 age- and sex-matched normal ears. RESULTS: Of the 18 patients with tinnitus, 12 had significantly increased hearing thresholds at more than one of the four high frequencies, compared with the normal group. When we assessed results according to frequency, we found that 8 patients had decreased hearing ability at 10 kHz, 10 at 12 kHz, 8 at 14 kHz, and 4 at 16 kHz. CONCLUSION: Some patients with tinnitus who have normal hearing below 8 kHz have decreased hearing ability at extended high-frequencies. Thus, the proportion of patients with tinnitus who have normal hearing over the entire audible range is smaller than in previous reports.
Audiometry ; Ear ; Hearing ; Hearing Loss ; Humans ; Tinnitus