Introduction : The aim of this study was to determine the significance of the effects of hearing loss and different hearing abilities of both ears on mental activity and social interaction in the elderly.
Methods : Fifty-six community dwelling elderly subjects were included in this study. Hearing acuity was measured and a questionnaire was undertaken in all subjects to evaluate their mental activity and social interaction. Based on the answers, the subjects were divided into (1) 3 groups, according to the level of hearing loss, and (2) 2 groups, according to the differences in hearing.
Results : (1) When hearing by audiometric testing was compared to mental activity, no direct effects were found. Based on the questionnaire results, the subjects in the group with the greatest hearing loss were determined to be psychologically affected, and they therefore avoided social interactions. These patients were at risk of being socially isolated. (2) One group showed differences in hearing abilities of both ears, which could be a possible risk factor for loneliness and depression.
Conclusion : This study suggests that hearing loss and different hearing ability of both ears affects mental activity and social interaction in the elderly. Both depression and being socially isolated are included under the Long-Term Care Prevention Project. It is necessary to determine the degree of hearing loss by using both subjective and objective evaluations.

Ascites is a rare sign of aortic valve disease. Here, we report two cases of refractory ascites that had resulted from aortic stenosis and insufficiency and consequently improved after aortic valve replacement. The first case was a 44-year-old female who had undergone aortic valve repair for aortic stenosis 15 years earlier. She complained of dyspnea and severe abdominal distension due to unimproved massive ascites despite medical therapy. She was diagnosed with aortic stenosis and insufficiency and functional tricuspid insufficiency as well as complete atrioventricular block. She underwent mechanical aortic valve replacement, tricuspid annuloplasty and DDD pacemaker implantation. The second case was a 61-year-old man with a history of alcoholic liver disease who had been hospitalized for massive ascites, progressing rapidly in spite of aggressive medical therapy. Echocardiography revealed severe aortic stenosis and insufficiency; thus, he underwent bioprosthetic aortic valve replacement. Both patients were completely free from ascites about 6 months after surgery.