BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: Carcinogens result in the impairment of intercellular communication as well as intracellular communication of normal cells. Connexin (Cx) is a main constituent protein of gap junctions that let messengers such as ions communicate between cells. We evaluated the effect of carcinogen H2O2 on the expression of Cxs and gap junction intercellular communication (GJIC) in the human keratinocyte cell line (HaCaT) and analyzed the prevention effect of green tea extracts against H2O2. MATERIALS AND METHOD: We performed neutral red dye uptake tests to determine the optimal concentrations of H2O2, green tea extracts-epicatechin (EC) and epigallocatechin-3-gallate (EGCG) in this study. To analyze the expression change of Cxs, we performed RT-PCR, Western blot, and immunocytochemistry after 24-hour culture of HaCaT cells treated with agents. We also evaluated GJIC quantitatively using the 'scrape loading dye transfer (SLDT)' technique. RESULTS: Cx26, Cx30, Cx31, Cx43, but not Cx29 were expressed in the HaCaT cells. H2O2 (250 uM) down-regulated Cx26 and Cx43 proteins. In HaCaT cells treated with H2O2, EC (175 uM) up-regulated Cx26 and Cx43 proteins, but EGCG (50 uM) up-regulated only Cx43 protein. Immunocytochemistry showed the decreased expression and abnormal location of Cx26 and Cx43 under H2O2, and EC and EGCG (5 uM) inhibited the effect of H2O2, showing similar staining in the control. In SLDT, H2O2 down-regulated GJIC, while EC and EGCG significantly prevented HaCaT cells from the H2O2-induced, down-regulation of GJIC. CONCLUSION: The carcinogen, H2O2, inhibits GJIC in the keratinocyte cell line. Green tea extracts, such as EC and EGCG, prevent GJIC inhibition in the keratinocyte cell line treated with H2O2, suggesting they have a potential anti-cancer properties.
Blotting, Western ; Carcinogens ; Catechin ; Cell Line ; Connexin 43 ; Down-Regulation ; Gap Junctions ; Humans ; Immunohistochemistry ; Ions ; Keratinocytes ; Linear Energy Transfer ; Neutral Red ; Proteins ; Tea

The acute vestibular neuritis is rarely seen in children and it is hard to find the related reports. In this paper, we report three cases of acute vestibular neuritis less than 15 years old that we experienced during last 10 years. The three cases are 14 and 11-year old boys and a 12-year-old-girl. They complained vertigo without hearing loss. Only one of three cases had previous common cold history and they showed all negative reactions in virus blood tests. After medical treatment and early rehabilitation, vertigo was completely controlled within 3 weeks and there was no recurrent symptoms so far. This recovery in children seems to be faster and more complete than in adults.
Adolescent ; Adult ; Child* ; Common Cold ; Hearing Loss ; Hematologic Tests ; Humans ; Rehabilitation ; Vertigo ; Vestibular Neuronitis*

BACKGROUND AND OBJECTIVES: Otitis media with effusion (OME) is one of the most common diseases in children and may be frequently related with dizziness. However, the association between OME and dizziness seems to be not clear and remains controversy. The purpose of this study was to determine the incidence of dizziness in children with long lasting OME, and to investigate the difference in vestibular functions between children with long lasting OME and the control group. MATERIALS AND METHOD: Thirty one children who had long-lasting OME over than 6 months (study group) and 28 normal hearing children without OME who were scheduled for adenotonsillectomy (control group), were given questionnaires and vestibular function tests (VFT) including electronystagmography (ENG) and rotation chair test (RCT). Statistical analysis was performed with chi-square test. RESULTS: Dizziness was found in 7 (22.6%) of 31 children in the study group and 2 (7.1%) of 28 children in the control group (p>0.05). The difference of abnormal findings in VFT between the study group and the control was not significant except visual vestibulo-ocular reflex (VVOR) in RCT. Most of the correlations in the study group, bilateral vs. unilateral OME, OME with dizziness vs. OME without dizziness, and preoperative vs. postoperative, were not significant. CONCLUSION: We did not find any evidences of significant difference of the incidence of dizziness and findings of VFT between children with long lasting OME and children without OME. However, there was a significant abnormal response in VVOR in RCT in children with long-lasting OME, suggesting the children with OME may be more dependent on the nonvestibular system including visual compensation to maintain balance.
Child* ; Compensation and Redress ; Dizziness ; Electronystagmography ; Hearing ; Humans ; Incidence ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Surveys and Questionnaires ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests

PURPOSE: The purpose of this study was to examine the validity of student ratings of instruction by analyzing their relationships with several variables, including gender, academic rank, specialty, teaching time, and teaching method, at a medical school. METHODS: This study analyzed the student ratings of 297 courses at Ajou University School of Medicine in 2013. SPSS version 12.0 was used to analyze the data and statistics by t-test, analysis of variance, and Scheffe test. RESULTS: There were no statistically significant differences in student ratings between gender, rank, and specialty. However, student ratings were significantly influenced by teaching times and methods (p<0.05). Student ratings were high for teaching times of 10 hours or more and small-group learning, compared with lectures. There was relatively mean differences in students ratings by teaching times, specialty and rank, although the difference in ratings was not statistically significant. CONCLUSION: Student ratings can be classified by teaching time and method for summative purposes. To apply student ratings to the evaluation of the performance of faculty, further studies are needed to analyze the variables that influence student ratings.
*Attitude ; *Curriculum ; *Education, Medical, Undergraduate ; Faculty/standards ; Female ; Humans ; *Learning ; Male ; *Schools, Medical ; *Students, Medical ; Surveys and Questionnaires ; Teaching/*standards

BACKGROUND AND OBJECTIVES: It is not easy to detect the small-sized vestibular schwannomas because they sometimes show atypical clinical presentation such as sudden deafness and detection by chance. However, it is very important to diagnose a vestibular schwannoma in the earlier stage to preserve facial nerve function and hearing. This study aimed to analyze clinical characteristics of small vestibular schwannomas and to make decision analysis of their diagnostic work-up. MATERIALS AND METHOD: we reviewed retrospectively 42 patients who were diagnosed with vestibular schwannoma of size less than 1.5cm at the Departments of Otolaryngology, Ajou University Hospital and Yonsei University Hospital from June, 1994 to May, 2002. This study analyzed chief complaints, size of tumor, audiological studies, caloric test, imaging study, and treatment modality. RESULT: Sixteen of 42 patients (38.1%) were in group IC , 20 patients (47.6%) for group 0 and 6 patients (14.3%) for group 1. One third of cases presented initial symptoms such as sudden hearing loss, the other third presented tinnitus, and 4 cases were detected by chance. Fourteen cases showed near normal hearing and auditory brainstem response (ABR) showed 76.2% sensitivity, which was relatively lower than we expected. CONCLUSION: Because acoustic neuroma was suspected in patients with unilateral hearing loss, tinnitus, and dizziness were very important considerations. We made the decision analysis in the diagnosis of small vestibular schwannoma. It consisted of earlier intervention of fast spin echo magnetic resonance imaging (MRI) based on a cost-effective approach.
Caloric Tests ; Decision Support Techniques ; Diagnosis ; Dizziness ; Evoked Potentials, Auditory, Brain Stem ; Facial Nerve ; Hearing ; Hearing Loss, Sudden ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Neuroma, Acoustic* ; Otolaryngology ; Retrospective Studies ; Tinnitus

BACKGROUND AND OBJECTIVES: GJB2 (Connexin 26), the gene of the gap-junction proteins, was found to be the main causative gene of autosomal recessive nonsyndromic hearing loss (DFNB1). Whereas 35delG was known as the major type mutation in the western countries, 235delC was reported as the specific form of mutation in Asian population. The objective of this study is to identify how two mutations (235 delC, E114G) found in the Korean population affect the function of GJB2 using the molecular biology techniques. MATERIALS AND METHODS: 235delC and E114G types of mutations were cloned in the pcDNA3 vector. HeLa cells were transfected with these cloned vectors by the liposome complex method. 1) The expression and subcellular localization of Cx26 were determined using antibodies against amino acid sequences in the intracellular loop (IL) and N-terminal (NT) portions of Cx26. 2) To analyze functions of the GJB2, we examined the lucifer yellow dye transfer between cells with scrape-loaded technique. We used the wild-type (WT) Cx26 of normal hearing as a positive control, and mock cells as a negative control. RESULTS: The immunocytochemical analysis showed that cells transfected with E114G and WT gave characteristic punctuated patterns of reaction in the cell membrane with both antibodies. However, 235delC cells were not stained with the anti-IL antibody but only with the anti-NT antibody slightly around the nucleus regions. In the functional study of GJB2, transfer of lucifer yellow dye into contiguous cells was detected in E114G but not in 235delC. CONCLUSION: The 235delC type of mutation showed loss of their targeting activity on the cell membrane. As a result, the function of gap junction channels were severely deteriorated. With the E114G type mutation, we didn't find any difference when compared with the WT transfected cells. Above data indicate that types of GJB2 mutation are closely related to the status of hearing loss due to altered function of gap junction protein.
Amino Acid Sequence ; Antibodies ; Asian Continental Ancestry Group ; Cell Membrane ; Clone Cells ; Connexins ; Gap Junctions* ; Hearing Loss* ; Hearing* ; HeLa Cells ; Humans ; Liposomes ; Molecular Biology

Recurrent iritis and oral/genital ulcers have been described for the first time as a separate pathological entity by the Turkish dermatologist Hulusi Behcet. Behcet disease is a chronic, multi-systemic disorder, which affects many organs as a result of vasculitis. The clinical manifestations are divided into two groups: major (oral ulcers, eye lesions, genital ulcerations, and skin lesions) and minor (arthritis, gastrointestinal lesions, epididymitis, thrombophlebitis, and central nervous system involvement) criteria. The incidence of hearing loss in Behcet disease has been reported as 12% to 80% in several studies. A 37-year-old man diagnosed as Behcet disease was admitted to our department with complaints of profound right hearing loss and dizziness. He was treated with steroid without improvement. After one year, he suffered from complete hearing loss on the left side. A temporal bone CT scan revealed right cochlear ossification. Cochlear implantation was performed within 4 weeks after the completion of steroid therapy in the left cochlea, which was partially obstructed by fibrotic tissue. However, the electrode was fully inserted without resistance. Wound healing complications were not encountered in the postoperative period. The hearing threshold was restored to 30 dBHL, while speech discrimination did not improve as much as expected. We propose that the routine hearing examinations be employed in the evaluation and management of Behcet disease. According to our experience, we find that cochlear implantation should be carried out at an early stage, before the development of labyrinthine ossification.
Adult ; Behcet Syndrome* ; Central Nervous System ; Cochlea ; Cochlear Implantation* ; Cochlear Implants* ; Deafness ; Dizziness ; Electrodes ; Epididymitis ; Hearing ; Hearing Loss ; Humans ; Incidence ; Iritis ; Male ; Postoperative Period ; Skin ; Speech Perception ; Temporal Bone ; Thrombophlebitis ; Tomography, X-Ray Computed ; Ulcer ; Vasculitis ; Wound Healing

BACKGROUND AND OBJECTIVES: Submandibular space might be estimated as the most common space of deep neck infection. It may, in certain cases, be treated conservatively with no need for early open surgical drainage. The purpose of this study is to review the clinical course and outcome in treatment of submandibular abscess. SUBJECTS AND METHOD: A retrospective study was peformed for 9 years on 49 cases admitted from June 1994 to January 2003 for deep neck infection limited to the submandibular space. All patients were treated with intravenous antibiotics. The conservative group was treated with antibiotics only or combination therapy with needle aspiration. The surgical group was treated with intraoral or external drainage. Contrast enhanced computed tomography (CT) imaging was conducted for all cases and had confirmed that they all had an abscess in the submandibular space. RESULTS: The mean period of hospitalization was 7.6 days, with 35 patients treated with IV antibiotics only and 3 patients with aspiration in the conservative group. On the other hand, 3 patients were treated with intraoral drainage and 8 patients with external drainage in the surgical group. One patient required tracheotomy because of severe dyspnea. There was no complication observed in any cases. CONCLUSION: SSubmandibular abscess is an infection of deep neck space and is considered as the most common infection. Conservative treatment is a good therapeutic choice in cases with localized submandibular absess.
Abscess* ; Anti-Bacterial Agents ; Drainage ; Dyspnea ; Hand ; Hospitalization ; Humans ; Neck ; Needles ; Retrospective Studies ; Tracheotomy