BACKGROUND AND OBJECTIVES: This study was designed to evaluate relation between frequencies of noise and tinnitus in noise-induced hearing loss and to elucidate mechanism of tinnitus in noise-induced hearing loss. MATERIALS AND METHODS: Four factories were selected, of which noise frequencies were different except one factory. Preliminary screening hearing test with a pure tone audiometer on 1000 and 4000 Hz was done. And if the hearing threshold was over 40 dB, history taking, otological examination, tympanometry, pure tone audiometry on 500, 1000, 2000, 4000, 6000 Hz were done. Noise was measured in 125, 250, 500, 1000, 2000, 4000, 8000 Hz. Tinnitus was measured using 1000, 2000, 4000 Hz pure tone. RESULTS: 1) Hearing loss was most severe in the 4000, 6000 Hz range. 2) In A factory, noise was most intense on 4000 Hz, in B factory on 2000 Hz, and in C and D factory on 1000 Hz. 3) Forty-three workers (42.2%) of total 102 subjects complained tinnitus. And frequency of tinnitus was 4000 Hz in 71 ears (89.9%) among 79 ears with tinnius. CONCLUSION: Regardless of the frequency of noise, most workers complain of 4 kHz tinnitus. And it was in accord with frequency of most severe hearing loss in the noise-induced hearing loss.
Acoustic Impedance Tests ; Audiometry ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced* ; Hearing Tests ; Mass Screening ; Noise* ; Tinnitus*

Background/Aims: Although gastric neuroendocrine tumors (NETs) are uncommon neoplasms, their prevalence is increasing. The clinical importance of the World Health Organization (WHO) classification of gastric NETs, compared with NETs in other organs, has been underestimated.This study aimed to systematically evaluate the clinical and pathologic characteristics of gastric NETs based on the 2019 WHO classification and to assess the survival outcomes of patients from a single-center with a long-term follow-up. Methods: The medical records of 427 patients with gastric NETs who underwent endoscopic or surgical resection between January 2000 and March 2020 were retrospectively reviewed. All specimens were reclassified according to the 2019 WHO classification. The clinicopathologic characteristics, treatment, and oncologic outcomes of 139 gastric NETs were analyzed. Results: The patients’ median age was 53.0 years (interquartile range [IQR], 46.0 to 63.0 years). The median follow-up period was 36.0 months (IQR, 15.0 to 63.0 months). Of the patients, 92, 44, and 3 had grades 1, 2, and 3 NETs, respectively. The mean tumor size significantly increased as the tumor grade increased (p=0.025). Patients with grades 2 and 3 gastric NETs more frequently had lymphovascular invasion (29.8% vs 10.9%, p=0.005) and deeper tissue invasion (8.5% vs 0%, p=0.012) than those with grade 1 tumors. The overall disease-specific survival rate was 100%. Two patients with grades 2-3 gastric NETs experienced extragastric recurrence. Conclusions Although gastric NETs have an excellent prognosis, grade 2 or grade 3 gastric NETs are associated with a larger size, deeper invasion, and extragastric recurrence, which require active treatment.

BACKGROUND: It is well known that collateral circulation has important roles in ischemic heart diseases. The method most commonly used at present to evaluate collateral flow is coronary angiography. However, there are debates about the functional significance of angiographically visible collaterals because angiography visualizes only vessels that are larger than 100um in diameter. Recent studies suggest that myocardial contrast echocardiography (MCE) is a useful method in assessing collateral flow because it uses small microvascular tracers (4-12um) as a contrast agent. By using MCE, this study evaluates the role of angiographically visible collaterals in patients with acute myocardial infarction (AMI) and chronic ischemic heart disease. METHOD: Forty-one patients who underwent coronary angiography and MCE were included in this study (22 patients with acute myocardial infarction and 19 patients with chronic ischemic heart disease). Antegrade coronary flow was less than TIMI 3 flow in all patients. Myocardial perfusion through collaterals with MCE was evaluated by injecting sonicated Hexabrix into nonobstructing coronary arteries. Angiographically visualized collateral vessels were analysed as four grades and compared with the degree of myocardial opacification by MCE through collateral vessels. RESULT: Angiographic collaterals were frequently observed in patients with AMI and chronic ischemic heart disease with< or = TIMI 2 flow . There was poor correlation between TIMI grade and the grade of collaterals by angiography in AMI (r--0.29, p-0.20) and chronic ischemic heart disease (r--0.31, p-0.19). There was no correlation between collateral grades and myocardial opacification by MCE through collateral vessels in AMI (r-0.07, p-NS) and chronic ischemic heart disease (r-0.10, p-NS). In patients with relatively well developed collaterals (Grade II or III), the ischemic zone was perfused better through collateral flow in the chronic ischemic heart disease group than in the AMI group (Mean Retrograde Opacification Index 0.84+/-0.23 vs 0.32+/-0.22, p<0A65A>0.05). CONCLUSION: The study suggests that the role of angiographically visible collaterals is different in chronic ischemic heart disease and acute myocardial infarction. The grade of angiographically visible collaterals does not imply the extent of perfusion to myocardum at risk through collateral vessels.
Angiography ; Collateral Circulation ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Heart ; Humans ; Ioxaglic Acid ; Myocardial Infarction ; Myocardial Ischemia* ; Perfusion*

OBJECTIVE: To investigate the clinical efficiency of the cervical cerclage for preventing preterm birth in asymptomatic women who showed a shortened cervix at the second trimester ultrasound METHODS: From January 1996 to December 2005, we retrospectively reviewed the medical records of pregnant women who received routine second trimester ultrasound (16~24 gestational weeks) without abdominal pain or bleeding at Cheil general hospital. Women with a short cervical length < or =25 mm were classified into cerclage and expectant group. Women who received cervical cerclage within 1 week after detection of cervical shortening without any change of cervical length and shape were included in cerclage group. Primary outcome was the frequency of delivery before 34 weeks' gestation. Secondary outcome was the most important risk factor for preterm delivery in pregnant women with short cervix. Chi-square test, t-test, and multiple logistic regression analysis were used for statistical analysis. P<0.05 was considered statistically significant. RESULTS: The mean gestational age at ultrasound was 21.6 weeks' gestation. A total of 111 women had short cervix, including 26 that were treated by cerclage and 85 managed expectantly. The proportion of preterm delivery before 34 weeks' gestation was higher in the cerclage group [38% (10 of 26)] than that of the expectant group [20% (17 of 85)], but there was no significant difference (P=0.069). In the univariate analysis, funneling (38% vs 16%, P=0.012) and cervical length < or =15 mm (47% vs 15%, P=0.069) were associated with preterm delivery before 34 weeks' gestation. In the multiple logistic regression analysis, a cervical length < or =15 mm had an adjusted odd ratio of 3.7 (95% CI 1.3~10.6) for preterm delivery before 34 weeks's gestation. CONCLUSIONS: These data suggest that cerclage in asymptomatic woman with a short cervix in the second trimester ultrasound does not prevent preterm delivery before 34 weeks of gestation. Woman with extremely shortened cervical length < or =15 mm needs intensive management for prevention of preterm delivery.
Abdominal Pain ; Cerclage, Cervical ; Cervical Length Measurement ; Cervix Uteri ; Female ; Gestational Age ; Hemorrhage ; Hospitals, General ; Humans ; Logistic Models ; Medical Records ; Pregnancy ; Pregnancy Trimester, Second ; Pregnant Women ; Premature Birth ; Retrospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVES: To determine the clinical application of otoacoustic emissions (OAE) in screening of cochlear function, author studied changes of OAE in Meniere's disease patients. MATERIALS AND METHODS: The author has measured several parameters of OAE with 34 meniere's patients and 15 normal persons. Pass rate, response amplitude, reproducibility were recorded at TEOAE. Amplitude of DP-gram were measured at 2 F2 frequencies-1000, 2000 Hz. The input/output functions of DPOAE were recorded at 2 F2 frequencies -1001, 2002 Hz (respectively DP-1000, DP-2000). Input/output function were determined based on 2 parameters- maximal level and Detection threshold of DPOAE. RESULTS: 1) TEOAE: Significant lower rate of positive finding was recorded at involved ears (55.8%, 19/34) than normal ears (100%, 30/30). 2) DP-gram: At frequency was 2000 Hz, amplitude of involved ears (n=28, 6.3+/-.5 dB/SPL) was significant smaller than normal ears (n=30, 6.3+/-.5 dB/SPL). 3) DP-input/output function: At maximum DP level of DP-2000, response of involved ears (n=11, 51.6+/-.9 dB/SPL) was significant larger than normal ears (n=22, 48.5+/-.0 dB/SPL). CONCLUSION: Parameters of OAE, such as pass rate of TEOAE, amplitude of DP-gram at 2000 Hz, and maximum DP level of DP-2000 was considered to good indicators for monitoring cochlear function of Meniere's disease. Furthermore, evaluation by changes in the TEOAE & DPOAE combined parameters, appeared to be very useful for detection of subtle change in cochlear function of Meniere's disease.
Ear ; Humans ; Mass Screening ; Meniere Disease*

BACKGROUND AND OBJECTIVES: To determine the clinical application of otoacoustic emissions (OAE) in screening of cochlear function, author studied changes of OAE in Meniere's disease patients. MATERIALS AND METHODS: The author has measured several parameters of OAE with 34 meniere's patients and 15 normal persons. Pass rate, response amplitude, reproducibility were recorded at TEOAE. Amplitude of DP-gram were measured at 2 F2 frequencies-1000, 2000 Hz. The input/output functions of DPOAE were recorded at 2 F2 frequencies -1001, 2002 Hz (respectively DP-1000, DP-2000). Input/output function were determined based on 2 parameters- maximal level and Detection threshold of DPOAE. RESULTS: 1) TEOAE: Significant lower rate of positive finding was recorded at involved ears (55.8%, 19/34) than normal ears (100%, 30/30). 2) DP-gram: At frequency was 2000 Hz, amplitude of involved ears (n=28, 6.3+/-.5 dB/SPL) was significant smaller than normal ears (n=30, 6.3+/-.5 dB/SPL). 3) DP-input/output function: At maximum DP level of DP-2000, response of involved ears (n=11, 51.6+/-.9 dB/SPL) was significant larger than normal ears (n=22, 48.5+/-.0 dB/SPL). CONCLUSION: Parameters of OAE, such as pass rate of TEOAE, amplitude of DP-gram at 2000 Hz, and maximum DP level of DP-2000 was considered to good indicators for monitoring cochlear function of Meniere's disease. Furthermore, evaluation by changes in the TEOAE & DPOAE combined parameters, appeared to be very useful for detection of subtle change in cochlear function of Meniere's disease.
Ear ; Humans ; Mass Screening ; Meniere Disease*

BACKGROUND AND OBJECTIVES: Hypopharyngeal cancer is notorious for its poor prognosis and severe surgical morbidity with functional deficits. This study was conducted to compare the efficacy between the neoadjuvant chemotherapy followed by radiotherapy and surgery with postoperative radiotherapy in the treatment of hypophayngeal cancer. MATERIAL AND METHOD: Medical records of 64 patients, treated for hypopharyneal cancer at Pusan National University Hospital from March 1986 through May 2000, were retrospectively reviewed. Thirty-three patients were grouped into the chemotherapy and radiotherapy (CRTx) group, who received neoadjuvant chemotherapy and radiotherapy. Thirty-one patients were grouped into the operation and radiotherapy (ORTx) group, who received laryngectomy with or without reconstruction and postoperative radiotherapy. RESULTS: There was no significant difference of three years survival rate between CRTx group and ORTx group (p>0.05). Laryngeal preservation rate was 45% in CRTx group but 3% in ORTx group (p<0.05). CONCLUSION: Although this had not been a randomized study of chemotherapy followed by radiotherapy versus surgery plus postoperative radiotherapy, the survival rate of CRTx group appears to be as identical as ORTx group and more effective in the preservation of the larynx.
Busan ; Drug Therapy* ; Humans ; Hypopharyngeal Neoplasms* ; Laryngectomy ; Larynx ; Medical Records ; Neoadjuvant Therapy ; Organ Preservation ; Prognosis ; Radiotherapy* ; Retrospective Studies ; Survival Rate

BACKGROUND/AIMS: Pregnancy-associated gastric cancer is a rare condition. This case-control study was performed to identify the clinicopathological features and prognostic factors of pregnancy-associated gastric cancer. METHODS: All consecutive patients who presented to our tertiary referral hospital with pregnancy-associated gastric cancer from 1991 to 2012 were identified. Two age-, sex-, and stage-matched controls for each case were also identified from the records. Clinicopathological, gynecological, and oncological outcomes were recorded. Immunohistochemical staining was performed for estrogen receptor, progesterone receptor, epidermal growth factor receptor, human epidermal growth factor receptor, and E-cadherin. Fluorescence in situ hybridization was performed for fibroblast growth factor receptor 2. RESULTS: The median overall survival rates of the pregnancy-associated gastric cancer and control groups were 7.0 months and 15.0 months, respectively (p=0.189). Poor prognostic factors included advanced stage and tumor location in the corpus or the entire stomach but not pregnancy status or loss of E-cadherin. Pregnancy-associated gastric cancer was associated with a longer time from diagnosis to treatment (21 days vs 7 days, p=0.021). The two groups did not differ in the expression of the receptors or E-cadherin. CONCLUSIONS: The dismal prognosis of pregnancy-associated gastric cancer may related to the tumor stage and location rather than to pregnancy itself.
Cadherins ; Case-Control Studies* ; Diagnosis ; Estrogens ; Fluorescence ; Humans ; In Situ Hybridization ; Pregnancy ; Prognosis* ; Receptor, Epidermal Growth Factor ; Receptor, Fibroblast Growth Factor, Type 2 ; Receptors, Progesterone ; Stomach ; Stomach Neoplasms* ; Survival Rate ; Tertiary Care Centers

BACKGROUND: Constipation occurs frequently in diabetes mellitus (DM). However, there are few reports that investigated the characteristics of constipation associated with DM. The purpose of this study was to evaluate the clinical features of constipation associated with DM. METHODS: Among constipated patients who visited Asan Medical Center from January 2000 to December 2004, 45 patients with DM (DM group) and 104 patients without DM (non-DM group) were included in this study. We reviewed the clinical presentation, results of anorectal manometry, colon transit time study, and defecogram. We also analyzed the response to biofeedback therapy. RESULTS: The severity of constipation symptoms before treatment was not different between DM and non-DM group. Patients with colon transit time over 56 hours were more frequent in DM group than in non-DM group (21/45, 46.7% vs. 31/104, 29.8% ; p=0.047). Among DM group, colon transit time and the duration of DM showed positive correlation (r=0.431, p=0.003). The resting anal sphincter pressure was significantly lower in DM group than in non-DM group (43.5+/-21.5 mmHg vs. 51.7+/-22.6 mmHg ; p=0.048). The results of defecography were similar between DM and non-DM group. Successful responses to biofeedback therapy were not different between DM and non-DM group (19/34, 55.9% vs. 43/79, 54.4% ; p=0.887). CONCLUSIONS: Slow transit constipation was more frequent in DM group than in non-DM group. The successful responses to biofeedback therapy appear to be similar between DM and non-DM group.
Anal Canal ; Biofeedback, Psychology ; Chungcheongnam-do ; Colon ; Constipation* ; Defecography ; Diabetes Mellitus* ; Humans ; Manometry ; Time and Motion Studies

Proton pump inhibitor (PPI)-based triple therapy consisting of PPI, amoxicillin, and clarithromycin, is the recommended first-line treatment for Helicobacter pylori infection. However, the eradication rate of triple therapy has declined over the past few decades. We analyzed the eradication rate and adverse events of triple therapy to evaluate current practices in Korea. A comprehensive literature search was performed up to August 2013 of 104 relevant studies comprising 42,124 patients. The overall eradication rate was 74.6% (95% confidence interval [CI], 72.1%-77.2%) by intention-to-treat analysis and 82.0% (95% CI, 80.8%-83.2%) by per-protocol analysis. The eradication rate decreased significantly from 1998 to 2013 (P < 0.001 for both intention-to-treat and per-protocol analyses). Adverse events were reported in 41 studies with 8,018 subjects with an overall incidence rate of 20.4% (95% CI, 19.6%-21.3%). The available data suggest that the effectiveness of standard triple therapy for H. pylori eradication has decreased to an unacceptable level. A novel therapeutic strategy is warranted to improve the effectiveness of first-line treatment for H. pylori infection in Korea.
Alkylating Agents/therapeutic use ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Anti-Ulcer Agents/therapeutic use ; Clarithromycin/therapeutic use ; *Communicable Disease Control ; Cytochrome P-450 CYP3A Inhibitors/therapeutic use ; *Disease Eradication ; *Drug Resistance, Bacterial ; Drug Therapy, Combination ; Gastritis/microbiology/pathology ; Helicobacter Infections/*drug therapy ; Helicobacter pylori ; Humans ; Metronidazole/therapeutic use ; Proton Pump Inhibitors/*therapeutic use ; Republic of Korea ; Tinidazole/therapeutic use