Objectives: . Intratympanic dexamethasone injection (ITDI) has been introduced as a treatment option for subjective tinnitus. However, the effects of ITDI on patients with tinnitus remain unclear. In the present systematic review and metaanalysis, we evaluated the effectiveness of ITDI for tinnitus treatment. Methods: . We searched Medline, the Cochrane Central Register of Controlled Trials, and Embase. Four double-blind randomized controlled trials that tested the efficacy of ITDI compared with a placebo were deemed eligible for a quantitative meta-analysis, while four prospective studies and seven retrospective studies reporting the effectiveness of ITDI on tinnitus treatment were included in a qualitative synthesis. Results: . In the four studies included in the quantitative meta-analysis, ITDI did not show evidence of tinnitus improvement compared with placebo (odds ratio [OR], 1.38; 95% confidence interval, 0.53–3.61). In the 11 studies included in the qualitative synthesis, seven retrospective studies without controls reported rates of tinnitus improvement after ITDI ranging from 35.9% to 91.3%. In the four prospective studies with controls, ITDI seemed to be effective when combined with other drugs for tinnitus treatment. Conclusion . ITDI alone did not show a significant effect for treating tinnitus compared with placebo. However, the potential of combination treatment of ITDI with other drugs for tinnitus therapy should be further studied in more systematic research.

Objectives: The purpose of this study is to investigate the difference in the effects of eye-mask and light-off on sleep status according to a commercial fitness tracker and a sleep diary of psychiatric in-patients in correctional facilities where nocturnal light is compulsory. Methods: This study was conducted over 3 consecutive nights. In-patients of the National Forensic Psychiatric Hospital (n = 29) were assigned random subject numbers and slept as usual in the light-on condition on the first night. The subjects slept with eye-masks in the light-on condition on another night and without an eye-mask in the light-off condition on the other night. Subjects were asked to sleep wearing a commercial fitness tracker and to keep a sleep diary. The order of these changes in bedroom lighting condition on the second and third nights was assigned randomly to participants. Results: In comparison of the sleep variables between the light-on condition and the eye-mask condition, the Wakefullness After Sleep Onset (WASO) was shorter and sleep satisfaction was higher in the latter.(respectively, Z = 3.66, p < 0.017 ; Z = 2.69, p < 0.017) In comparison of the sleep variables between the light-on and light-off conditions, the WASO was shorter and sleep efficiency and sleep satisfaction were higher in the latter (respectively, Z = 2.40, p < 0.017 ; Z = 3.02, p < 0.017 ; Z = 3.88, p < 0.017). However, there were no differences in the sleep variables between the eye-mask condition and the light-off condition. Conclusion Subjective improvements in sleep variables were noted in sleep diaries of institutionalized psychiatric patients under either the ‘eye-mask’ or ‘light-off’ condition. However, there were no significant differences between the ‘eye-mask’ and ‘light-off’ conditions. Therefore, we suggest that psychiatric patients in correctional facilities use eye-masks when sleeping.

Objectives: The purpose of this study is to investigate the difference in the effects of eye-mask and light-off on sleep status according to a commercial fitness tracker and a sleep diary of psychiatric in-patients in correctional facilities where nocturnal light is compulsory. Methods: This study was conducted over 3 consecutive nights. In-patients of the National Forensic Psychiatric Hospital (n = 29) were assigned random subject numbers and slept as usual in the light-on condition on the first night. The subjects slept with eye-masks in the light-on condition on another night and without an eye-mask in the light-off condition on the other night. Subjects were asked to sleep wearing a commercial fitness tracker and to keep a sleep diary. The order of these changes in bedroom lighting condition on the second and third nights was assigned randomly to participants. Results: In comparison of the sleep variables between the light-on condition and the eye-mask condition, the Wakefullness After Sleep Onset (WASO) was shorter and sleep satisfaction was higher in the latter.(respectively, Z = 3.66, p < 0.017 ; Z = 2.69, p < 0.017) In comparison of the sleep variables between the light-on and light-off conditions, the WASO was shorter and sleep efficiency and sleep satisfaction were higher in the latter (respectively, Z = 2.40, p < 0.017 ; Z = 3.02, p < 0.017 ; Z = 3.88, p < 0.017). However, there were no differences in the sleep variables between the eye-mask condition and the light-off condition. Conclusion Subjective improvements in sleep variables were noted in sleep diaries of institutionalized psychiatric patients under either the ‘eye-mask’ or ‘light-off’ condition. However, there were no significant differences between the ‘eye-mask’ and ‘light-off’ conditions. Therefore, we suggest that psychiatric patients in correctional facilities use eye-masks when sleeping.

Since the first-in-man transcatheter delivery of an aortic valve prosthesis in 2002, the landscape of aortic stenosis therapeutics has shifted dramatically. While initially restricted to non-surgical cases, progressive advances in transcatheter aortic valve replacement and our understanding of its safety and efficacy have expanded its use in intermediate and possibly low surgical risk patients. In this review, we explore the past, present, and future of transcatheter aortic valve replacement.
Aortic Valve ; Aortic Valve Stenosis ; Humans ; Prostheses and Implants ; Transcatheter Aortic Valve Replacement*

No abstract available.

OBJECTIVES: Tympanic membrane perforations are common, but there have been few studies of the factors determining the extent of the resulting conductive hearing loss. The aims of this study were to determine whether the size of tympanic membrane perforation, pneumatization of middle ear & mastoid cavity, and location of perforation were correlated with air-bone gap (ABG) of patients. METHODS: Forty-two patients who underwent tympanoplasty type I or myringoplasty were included and preoperative audiometry were analyzed. Digital image processing was applied in computed tomography for the estimation of middle ear & mastoid pneumatization volume and tympanic membrane photograph for the evaluation of perforation size and location. RESULTS: Preoperative mean ABG increased with perforation size (P=0.018), and correlated inversely with the middle ear & mastoid volume (P=0.005). However, perforations in anterior versus posterior locations showed no significant differences in mean ABG (P=0.924). CONCLUSION: The degree of conductive hearing loss resulting from a tympanic membrane perforation would be expected with the size of perforation and pneumatization of middle ear and mastoid.
Audiometry ; Ear, Middle ; Hearing Loss, Conductive* ; Humans ; Mastoid ; Myringoplasty ; Tympanic Membrane ; Tympanic Membrane Perforation* ; Tympanoplasty

The sixth author's name should have been given as Myung-Whan Suh.

OBJECTIVE: To assess whether the order of test diets influences the results of swallowing studies with regard to their accuracy and safety. METHODS: Subjects with suspected dysphagia underwent a videofluoroscopic swallowing study (VFSS) and/or a fiberoptic endoscopic evaluation of swallowing (FEES) and repeated the study on the same day or within a week. The order of test diets comprised of two different sets: trial 1 with the fluid first and trial 2 with the semi-solid food first. Main outcome measurements were the modified penetration-aspiration scale (mPAS) and the pharyngeal residue severity scale (PRSS) for the vallecula and the pyriform sinus. RESULTS: Sixty-six patients (44 men and 22 women, aged 65.0+/-15.0 years) were enrolled in this study. Forty-three subjects were evaluated with VFSS only and 23 with both VFSS and FEES. As a result of the swallowing studies, there was no significant difference in each chosen diet sequence regarding mPAS and PRSS. Furthermore, there was no difference regarding the duration of studies, rate of premature study termination, rate of abnormal findings in post-study chest X-ray, and rate of fever or pneumonia post-study. CONCLUSION: The accuracy and safety of the swallowing studies do not rely on the order of test diets.
Deglutition Disorders ; Deglutition* ; Diet* ; Fees and Charges ; Female ; Fever ; Humans ; Male ; Pneumonia ; Pyriform Sinus ; Thorax

There are only a few reports of post-traumatic Meniere's disease and there is few literature that contains detailed data associated with the disease. We report a case of post-traumatic Meniere's disease. He suffered from tinnitus, fluctuating sensorineural hearing loss, and recurrent vertigo. Symptomatic medical treatment was not helpful and neither was soft tissue plugging around the oval and round windows during exploratory tympanotomy. Three months after soft tissue plugging, endolymphatic sac decompression surgery was performed. The patient's symptoms improved markedly thereafter. The clinical significance of post-traumatic Meniere's disease is described and we present a brief review of the literature.
Decompression ; Endolymphatic Hydrops ; Endolymphatic Sac ; Hearing Loss, Sensorineural ; Meniere Disease* ; Tinnitus ; Vertigo

We report on operational and rehabilitation management, as well as the outcome, of a patient who with sustained spinal cord injury from a high velocity gunshot wound to the lumbar spine. More specifically, a patient with a gunshot wound to the spine is more likely to sustain a complete injury and have a poor prognosis. As such, there should be concerns regarding associated and extended injuries related to bullet fragmentation as well as the possibility of long-term sequelae.
Forensic Ballistics ; Humans ; Prognosis ; Spinal Cord ; Spinal Cord Injuries ; Spine ; Wounds, Gunshot