BACKGROUND: The purposes of this study were (1) to investigate the abilities of word definition in patients with Alzheimer's disease (AD) according to the severity, and (2) to examine the error patterns in patients with Alzheimer's disease. METHODS: Eight individuals with MCI (CDR=0.5) and 16 patients with AD (eight for probable AD mild group of CDR=1 and eight for probable AD moderate group of CDR=2) participated in the study. Eight normal age-, gender-, and education-matched elderly adults served as a control group for the MCI and AD groups. As stimuli for the word definition, eleven semantic categories were used, and two concrete words were selected from each category, resulting in a total of 22 items. Prior to the task, four definition categories were provided: 1) functional, 2) relational, 3) perceptual, and 4) categorical. Statistical analyses were performed using Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: There were significant differences in word definition scores among four groups. The probable AD moderate group showed the lower definition score than the probable AD mild group. And the probable AD moderate group showed the lower definition score than MCI group. Each group defined words in different ways. While the control group employed four definition different categories equally, the probable AD moderate group used a functional definition category mainly. However, relational and categorical definition categories were rarely observed in the probable AD moderate group. The analysis of error pattern showed that inadequate definition was frequently observed in all groups. CONCLUSIONS: The results from this study suggest that word definition task could be a sensitive indicator of the impairment of semantic knowledge in patients with AD.
Adult ; Aged ; Alzheimer Disease* ; Humans ; Mild Cognitive Impairment ; Semantics

OBJECTIVES: The purpose of this study was to obtain sex- and age-specific reference level for hearing threshold of normal aging in Korean and to determine if the rate of change in pure-tone hearing thresholds differed by sex. METHODS: Subjects were clients who visited the Health Promotion Center, Daegu Fatima Hospital, Daegu, Korea, from January 2004 to September 2005. Pure-tone audiometric measures were obtained from 3,470 subjects who also completed a hearing questionnaire. The slope of a linear regression was used to estimate the rate of change in pure-tone thresholds at 0.25 to 8 kHz for each ear in 214 men and 902 women without past history of otorrhea, usage of ototoxic drugs, head injury, job in noisy environment, and military service. RESULTS: Hearing thresholds were elevated with age in all test frequencies. Significant sex differences were found in pure-tone thresholds at 4 and 8 kHz after adjusting for age using analysis of covariance. In those high frequencies, hearing was worse in men than in women. The average rate of change in threshold was 0.28 and 0.24 dB per year at 0.25 kHz, increasing gradually to 1.27 and 1.05 dB per year at 8 kHz for men and women, respectively. Men had significantly faster rates of threshold increase at 4 and 8 kHz than women. CONCLUSION: These cross-sectional measures of hearing levels and rate of threshold increases at 4 and 8 kHz showed significant sex differences in Korean men and women with little evidence of noise-induced hearing loss.
Aging ; Auditory Threshold ; Craniocerebral Trauma ; Ear ; Female ; Health Promotion ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced ; Humans ; Korea ; Linear Models ; Male ; Military Personnel ; Sex Characteristics ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Auditory brainstem response (ABR) can be utilized to verify the hearing threshold and determine the existence of retrocochlear pathology in sudden deafness. However, little is known about the significance of ABR characteristics as a prognostic factor in sudden deafness. The purpose of this study is to evaluate which characteristics of ABR is associated with the prognosis of sudden deafness. SUBJECTS AND METHOD: We studied patients who were diagnosed with unilateral sudden deafness from January 2017 to May 2018. ABR results of click stimuli at 90 dB nHL were analyzed by the latency of wave I, III, and V. RESULTS: A total of 113 patients (55 men and 58 women) participated in the study. Hearing recovery was observed in 94 cases (83.2%). The absolute latency of wave I, III, and V was prolonged in the affected ears when compared with the unaffected ears. Hearing improvement was only correlated to the interaural latency delay of wave I (Pearson's r=−0.278, p<0.05). Prolonged interaural latency delay was noted from complete toward slight hearing recovery group. When the hearing outcome was evaluated by the interaural latency delay of wave I at 0.2 ms, the result of under 0.2 ms was significantly better than that over 0.2 ms and no visible wave I. CONCLUSION: Prolonged interaural delay of wave I over 0.2 ms and no visible wave I in ABR showed worse hearing outcome in sudden deafness. This finding may provide ABR as a potential prognostic indicator in sudden deafness.
Ear ; Evoked Potentials ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss, Sudden ; Hearing ; Humans ; Male ; Methods ; Pathology ; Prognosis

Spontaneous nystagmus is a reflection of tonic left-right vestibular asymmetry. It is typically seen after a recent unilateral peripheral vestibular lesion and has fast phases away from the side of the lesion. Sometimes spontaneous nystagmus is seen in the absence of a recent unilateral peripheral lesion, in which case it provides evidence of a vestibular lesion but does not localize it. We experienced a case of 35-year-old man who had sudden sensorineural hearing loss on the left side with acute onset of vertigo and transient spontaneous nystagmus, which had fast phases away from the side of the sudden deafness, without canal paresis on the bithermal caloric test.
Adult ; Caloric Tests ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Nystagmus, Pathologic ; Paresis ; Vertigo

Actinomycosis is rarely accompanied by fungus balls. It is difficult to distinguish between actinomycosis and a fungus ball due to their similar clinical and computed tomography scan results. Thus, a meticulous histopathological examination is required for definite diagnosis. We report a case of actinomycosis accompanied by a fungus ball, found incidentally in a patient without rhinologic symptoms. The patient was successfully treated with endoscopic sinus surgery, followed by short-term antibiotic therapy. We suggest that shortterm antibiotic therapy may be more appropriate than long-term antibiotic therapy based on our case study as well as several other studies.

BACKGROUND AND OBJECTIVES: Auditory brainstem response (ABR) can be utilized to verify the hearing threshold and determine the existence of retrocochlear pathology in sudden deafness. However, little is known about the significance of ABR characteristics as a prognostic factor in sudden deafness. The purpose of this study is to evaluate which characteristics of ABR is associated with the prognosis of sudden deafness.SUBJECTS AND METHOD: We studied patients who were diagnosed with unilateral sudden deafness from January 2017 to May 2018. ABR results of click stimuli at 90 dB nHL were analyzed by the latency of wave I, III, and V. RESULTS: A total of 113 patients (55 men and 58 women) participated in the study. Hearing recovery was observed in 94 cases (83.2%). The absolute latency of wave I, III, and V was prolonged in the affected ears when compared with the unaffected ears. Hearing improvement was only correlated to the interaural latency delay of wave I (Pearson's r=−0.278, p<0.05). Prolonged interaural latency delay was noted from complete toward slight hearing recovery group. When the hearing outcome was evaluated by the interaural latency delay of wave I at 0.2 ms, the result of under 0.2 ms was significantly better than that over 0.2 ms and no visible wave I. CONCLUSION Prolonged interaural delay of wave I over 0.2 ms and no visible wave I in ABR showed worse hearing outcome in sudden deafness. This finding may provide ABR as a potential prognostic indicator in sudden deafness.

Vegetative electrode infection after implantation of permanent pacemaker or defibrillator is an uncommon but a serious complication. Diagnosis of the lead infection is particularly important since surgical manipulation is usually required for its treatment. We present 3 cases of electrodes related infective endocarditis among the 154 patients who implanted pacemaker or defibrillator between 2001 and 2004 in Korea university hospital. These complications were difficult to diagnose because of ambiguous clinical manifestations and indeterminate transthoracic echocardiographic (TTE) findings and were finally confirmed by transesophageal echocardiography (TEE).
Defibrillators ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal* ; Electrodes* ; Endocarditis* ; Humans ; Korea ; Pacemaker, Artificial

BACKGROUND AND OBJECTIVES: Bone conduction (BC) auditory brainstem response (ABR) is an important factor in determining the type of hearing loss especially in infants and other difficult-to-test populations. However, multiple constraints including technical difficulties make evaluating BC ABR less feasible in the clinic, and there is also lack of information that guides clinicians how to evaluate it. The purpose of this study is to compare the latency of wave V in BC and air conduction (AC) ABR in normal hearing infants and gather reference values for wave V latency of BC ABR. SUBJECTS AND METHOD: A total of 210 ears of normal hearing, of those not belong to the hearing loss risk group, were included. All the infants underwent ABR evoked by clicks via AC (3A insert phone) and BC (Radioear B-71, vibrator positioned on the mastoid) under sedation. The latency of wave V at 30 dB nHL by BC and AC was compared and analyzed according to age. RESULTS: The results revealed that in every age group in the study, wave V latency at 30 dB nHL of BC ABR was shorter than that of AC ABR. There was a significant decrease in BC and AC latencies with age, but among each consecutive age group, significant latency change was not identified after 6 months old. CONCLUSION: The latency of BC ABR in young children was shorter than that of AC ABR, and it decreased significantly as age increased. However, the reference data should be considered by taking each laboratory's test parameter into consideration.
Bone Conduction* ; Child ; Ear ; Evoked Potentials ; Evoked Potentials, Auditory, Brain Stem* ; Hearing Loss ; Hearing* ; Humans ; Infant* ; Reference Values

BACKGROUND AND OBJECTIVES: Dizziness has been known as a prognostic factor in sudden sensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjective symptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensive evaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associated with disease severity and hearing outcome. SUBJECTS AND METHOD: A retrospective chart review was conducted of 488 patients diagnosed as unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis >20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologic findings and final hearing outcomes were compared between the two groups. RESULTS: The initial pure tone averages of SSHL patients of abnormal caloric group and normal caloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patients of abnormal caloric test group showed worse hearing outcome across all frequencies compared to those of the normal caloric group. Also, a significant correlation was noted between the magnitude of hearing recovery and canal paresis (r=-0.223, p < 0.001). CONCLUSION: SSHL patients of abnormal caloric test showed worse initial hearing level and poorer hearing outcome. Evaluation of vestibular function in SSHL patients is important because subjective symptoms alone cannot account for vestibular hypofunction patients, and the caloric test can help in the counseling of patients and prediction of hearing outcome in SSHL patients.
Caloric Tests* ; Counseling ; Dizziness ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Methods ; Paresis ; Retrospective Studies

The prognostic role of resting pulmonary hyperinflation as measured by residual volume (RV)/total lung capacity (TLC) in chronic obstructive pulmonary disease (COPD) remains poorly understood. Therefore, this study aimed to identify the factors related to resting pulmonary hyperinflation in COPD and to determine whether resting pulmonary hyperinflation is a prognostic factor in COPD. In total, 353 patients with COPD in the Korean Obstructive Lung Disease cohort recruited from 16 hospitals were enrolled. Resting pulmonary hyperinflation was defined as RV/TLC > or = 40%. Multivariate logistic regression analysis demonstrated that older age (P = 0.001), lower forced expiratory volume in 1 second (FEV1) (P < 0.001), higher St. George Respiratory Questionnaire (SGRQ) score (P = 0.019), and higher emphysema index (P = 0.010) were associated independently with resting hyperinflation. Multivariate Cox regression model that included age, gender, dyspnea scale, SGRQ, RV/TLC, and 6-min walking distance revealed that an older age (HR = 1.07, P = 0.027), a higher RV/TLC (HR = 1.04, P = 0.025), and a shorter 6-min walking distance (HR = 0.99, P < 0.001) were independent predictors of all-cause mortality. Our data showed that older age, higher emphysema index, higher SGRQ score, and lower FEV1 were associated independently with resting pulmonary hyperinflation in COPD. RV/TLC is an independent risk factor for all-cause mortality in COPD.
Aged ; Dyspnea/diagnosis/physiopathology ; Exercise Test ; Exercise Tolerance ; Female ; Forced Expiratory Flow Rates/physiology ; Forced Expiratory Volume ; Humans ; Lung/*physiopathology ; Male ; Middle Aged ; Prognosis ; Pulmonary Disease, Chronic Obstructive/*diagnosis/mortality/physiopathology ; Pulmonary Emphysema/*diagnosis/mortality/physiopathology ; Republic of Korea ; Residual Volume/*physiology ; Respiratory Function Tests ; Surveys and Questionnaires ; Total Lung Capacity/*physiology ; Vital Capacity ; Walking/physiology