BACKGROUND AND OBJECTIVES: Ginkgo biloba extract (GBE) enhances cell survival in various organs. GBE protects nerve cells in the central nervous system and is clinically applied in Parkinson's and Alzheimer's disease. GBE can protect ototoxicity caused by cisplantin and gentamycin through rescue of hair cells in Organ of Corti and is accepted as one of the therapeutic agents for sudden deafness and tinnitus. The experimental study on GBE for the inner ear is confined to the hair cells, not to the spiral ganglion neurons (SGNs) which is the stimulated part by the electrode of cochlear implant. The aim of this study is to elucidate the effect of GBE on the survival of SGNs after hair cell loss in rats. MATERIALS AND METHOD: Ten Sprague-Dawley rats aged 50 days (P50) were deafened with kanamycin sulfate. GBE (EGb 761) was injected into the right cochlea and artificial perilymph was injected into the left side. The number and size of SGNs were compared after immunohistochemical statin in both groups. The expression of pJun, which is well-known as a proapoptotic transcription factor in the cochlea, was also compared. RESULTS: The number of SGNs was significantly larger in the GBE group than the control. The expression of pJun activity was significantly decreased in GBE group than the control. The size of SGNs in both groups was similar. CONCLUSION: These results suggest that GBE can protect SGNs death by inhibiting the pJun-C-jun N-terminal kinase pathway. GBE might be a potential drug for the patients with total deafness before or after cochlear implantation surgery for better hearing results.
Aged ; Alzheimer Disease ; Animals ; Cell Survival ; Central Nervous System ; Cochlea ; Cochlear Implantation ; Cochlear Implants ; Deafness ; Ear, Inner ; Electrodes ; Gentamicins ; Ginkgo biloba ; Hair ; Hearing ; Hearing Loss, Sudden ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Kanamycin ; Neurons ; Organ of Corti ; Perilymph ; Phosphotransferases ; Rats ; Rats, Sprague-Dawley ; Spiral Ganglion ; Tinnitus ; Transcription Factors

BACKGROUND AND OBJECTIVES: Stapedial reflex (SR) threshold is of considerable diagnostic significance in the evaluation of audiological function, especially under sedation or general anesthesia since anesthetic drugs often act on neurotransmitters or neuromodulators. The aim of this study was to evaluate the changes in the SR threshold according to the depth of anesthesia. SUBJECTS AND METHOD: Sixty patients with normal hearing who were scheduled for operation under general anesthesia were included in this study. Anesthetic agent used was propofol and the depth of anesthesia was monitored by the bispectral index (BIS). SR was measured five times according to depth of anesthesia. RESULTS: Both ipsilateral and contralateral SR thresholds were increased according to the depth of anesthesia using propofol. In particular, ipsilateral SR showed no response at BIS 60 and contralateral SR at BIS 40. However, there were no significant differences between age groups and gender. CONCLUSION: Propofol significantly increased both ipsilateral and contralateral SR threshold according to depth of anesthesia. When it is necessary to measure SR under general anesthesia, we should consider the effect on SR threshold according to the depth of anesthesia.
Anesthesia ; Anesthesia, General ; Anesthetics ; Cellulose ; Hearing ; Humans ; Neurotransmitter Agents ; Propofol ; Reflex ; Reflex, Acoustic

BACKGROUND AND OBJECTIVES: A distortion product otoacoustic emission (DPOAE) is a non-invasive method which is commonly used to assess the hearing function of the cochlea and to reflect objective information of specific frequency in the cochlea. We hypothesize that after applying a broad band noise (BBN), the outer hair cell's function will change and cause reduction in the amplitude of DPOAEs and signal to noise ratio (SNR). SUBJECTS AND METHOD: We performed the examination on 40 subjects (80 ears) who have a normal hearing function. DPOAEs were recorded before and after BBN stimulation (intensity: 90 dB HL, duration: 10 minutes). RESULTS: After the BBN stimulation, the amplitude of DPOAEs and SNR were decreased at all frequencies. The amplitude of DPOAEs and SNR decreased 0.3-1.6 dB SPL, 0.6-1.5 dB SPL, respectively. Decreases in the amplitude had statistical significances after 3 and 6 minutes in 1 kHz, 3 and 6 minutes in 2 kHz, immediately after noise exposure, and after 3 and 6 minutes in 6 kHz. However, the SNR changes had statistical significance only after 3 minutes in 1 kHz. After the stimulation, pure tone threshold at 4 kHz increased 3.2+/-3.9 dB HL. After the BBN exposure, the amplitude of DPOAEs and SNR decreased at all frequencies and most of them recovered within 12 minutes. CONCLUSION: These results suggest that DPOAE could be a clinically useful method for the purpose of screening, managing and assessing the prognosis of acoustic trauma and noise induced sensorineural hearing loss.
Auditory Fatigue ; Cochlea ; Hair ; Hearing ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Mass Screening ; Noise ; Prognosis ; Signal-To-Noise Ratio

BACKGROUND AND OBJECTIVES: We investigated the relationship between the degree of enophthalmos and the volume of herniated orbital tissue measured from computed tomography scan in the isolated blowout fractures of orbital wall. SUBJECTS AND METHOD: In this retrospective study, 100 patients with isolated blowout fractures were evaluated. We classified them into 4 groups according to the site of fracture (medial and inferior) and the presence of symptoms like diplopia and limitation of ocular motility, which needs an operation. The volume of orbit and herniated orbital tissue has been measured by computed tomography scans using three-dimensional reconstruction technique, and the degree of enophthalmos was evaluated with Hertel's ophthalmometer. We compared the volume from which we got from the computed tomography scan, the degree of enophthalmos and the presence of symptoms to figure out the mutual relation between the groups. RESULTS: In the case of medial blowout fracture group, the volume of herniated orbital tissues increased significantly with the presence of symptoms and was in proportion to the extent of enophthalmos (p<0.05). The volume expansion of orbit associated with 2 mm of enophthalmos as calculated by the regression curve was 3.1 ml or 12.8 % in the no-symptoms groups. Finally, in the case of inferior blowout fracture group, there was no evidence of mutual relation. CONCLUSION: These results suggest that surgical intervention is required even though there isn't any symptom for medial blowout fractures, especially when the orbit volume is more than 12.8%. In cases of inferior blowout fractures, a close follow-up is needed even though the extent of fracture is small.
Diplopia ; Enophthalmos ; Follow-Up Studies ; Humans ; Orbit ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Vestibular evoked myogenic potentials (VEMP) have become a good diagnostic tool to evaluate the integrity of the vestibulocollic reflex. To investigate the standard recording of VEMP response in normal hearing subjects, the authors studied the effects of test positions and different acoustic stimulations on the VEMP. SUBJECTS AND METHOD: We performed VEMP on both ears of thirty normal hearing volunteers. Three acoustic stimulations (clicks and 500 Hz and 1,000 Hz short tone bursts) and four test positions were presented alternately to evoke VEMP. The latencies of peak p13 and n23, p13n23 interpeak latency (IPL) and amplitude were measured by EMG equipment and compared by statistical program. We also made up questions for the compliance of the test positions. RESULTS: The effects of test positions p13 latency had no significant difference on all test positions except between test position 2 and 4, n23 latency and p13n23 IPL had shortest waveform on test position 2, p13n23 amplitude had the largest waveform in test position 4. Acoustic stimulations on all test positions were influenced that clicks had shorter waveform about 2-3 ms than STBs on p13 latency and n23 latency, STBs had larger waveform than clicks on p13n23 amplitude. And the compliance of the test positions exhibited highest comfort in test position 1. CONCLUSION: Test position 1 had higher VEMP response rates and compliance, 500 Hz STB had a largest p13n23 amplitude. Therefore we recommend that the ideal conditions were position 1 and 500 Hz STB for acoustic stimulations to evoke VEMP.
Acoustics* ; Compliance ; Ear ; Hearing ; Reflex ; Vestibular Evoked Myogenic Potentials* ; Volunteers

BACKGROUND AND OBJECTIVES: Many researchers have attempted to correlate tumor marker expression with the response of chemoradiotherapy and prognosis of head and neck cancer. But no clear markers are available that can predict responses to treatment or survival in head and neck cancer. This study investigates the relationship between tumor marker expressions and prognosis. SUBJECTS AND METHOD: Thirty-eight patients who received cisplatin and 5-fluorouracil (5-FU) chemotherapy for the treatment of head and neck cancer were enrolled in this study. Author evaluated the relationship between the response of chemotherapy and the immunohistochemical expression of p53, Bcl-2, VEGF, PCNA. The relationship between survival and tumor marker expression was evaluated in twenty five patients who received chemotherapy and radiotherapy. RESULTS: Expression rates of p53, Bcl-2, VEGF, PCNA were 65%, 26%, 26%, 68%, respectively. Of the markers examined, while the expression of p53 was associated with chemosensitivity (p=0.02), other markers was not associated with chemosensitivity (p>0.05). The recurrent rate was 52%. T stage seemed to be associated with recurrence (p=0.07), tumor markers and other clinical parameters were not associated with recurrence (p>0.05). Five year survival rate was 60%. The primary site of tumor seemed to be associated with the overall survival rate of (p=0.07). Any other clinical characteristics and tumor markers were not associated with survival. CONCLUSION: The expression of p53 may be a clinically useful predictor of chemosensitivity in this group of patients. Further studies using a larger group is needed to establish the relationship between tumor markers and prognosis of head neck cancer.
Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Cisplatin* ; Drug Therapy ; Fluorouracil ; Head and Neck Neoplasms ; Head* ; Humans ; Neck* ; Prognosis* ; Proliferating Cell Nuclear Antigen* ; Radiotherapy ; Recurrence ; Survival Rate ; Biomarkers, Tumor ; Vascular Endothelial Growth Factor A*

BACKGROUND AND OBJECTIVES: Recently, internet-based applications of medicine are in the process of rapid development, where concepts of telemedicine and multimedia are important in these application. Hearing test is one of the essential procedures in the otologic field, especially in telediagnosis. A current study for tele-hearing test has some limitations in masking problems or making fully automated system. The aim of this study is to develop a digital air-conduction pure tone audiometer with automated making, which can be used through web-based or off-line to compare the threshold of hearing using conventional and digitalized audiometer in both normal and handicapped hearer. SUBJECTS AND METHOD: To develop an automated audiometer system, we prepared a test scenario data file according to the pure tone test procedure. This scenario was executed in the audiometer main, which is supported by sound card and keyboard (mouse) for output and feedback, respectively, for the examinee. Pure tone for test and white band noise for masking is generated in audiometer sound generation block. To compare this automated audiometer with the conventional one, 25 normal hearers (50 ears) and 25 handicapped hearers (50 ears) were tested. RESULTS: Easy Audiometer 1.0 was developed. The difference of hearing threshold between the two different system was 3-6 dB in the normal hearer group and 2.5-3.5 dB in the handicapped hearer group. Scatter plots showed a close relationship between these two different systems. CONCLUSION: Easy Audiometer 1.0 showed reliable results of hearing threshold in the patient with unilateral hearing who needs masking procedure. Screening and basic hearing tests may be conducted through this Easy Audiometer 1.0 and it could play a part in telediagnosis in the otologic field.
Information Storage and Retrieval ; Disabled Persons ; Hearing ; Hearing Tests ; Humans ; Masks* ; Mass Screening ; Multimedia ; Noise ; Telemedicine

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: Treatment of head and neck cancer with cisplatin-based combination chemotherapy has yielded increased complete response rates. In spite of the initial good response, recurrent cancer after chemotherapy does not respond to cisplatin based chemotherapy. In recent years, the analogues of taxol have used in a new chemotherapy treatments for head and neck cancer. The purpose of this study was to develop the acquired resistance to cisplatin in head and neck cancer cell line and to study the cross-resistance of docetaxel and 5-fluorouracil (5-FU) as compared to the parental cells in vitro. SUBJECTS AND METHOD: Two different human head and neck cancer cell lines (PNUH-12, SNU-899) were studied. We developed two cisplatin resistant cell lines (PNUH-12 R1, SNU-899 R1) by exposing them to near continuous increasing concentration of cisplatin. The morphology, growth curve of resistant cell lines were studied and the resistance of these cell lines to the cisplatin, docetaxel and 5-FU were compared to that of parental cells by MTT assay. RESULTS: The pattern of growth and shape of PNUH-12 R1 and SNU 899 R1 cell lines showed similarity to their parent cell lines. The growth curve of these cell lines were suppressed when compared with the parental cells. When compared to the parental cells, PNUH-12 R1 cells were 2.0-fold, 3.8-fold, and 1.4-fold resistant, and SNU 899 R1 cells 3.5-fold, 6.7-fold, and 15.0-fold resistant to cisplatin, docetaxel and 5-FU, respectively. CONCLUSION: In our study, cisplatin resistant cell lines of head and neck cancer have strong cross-resistance to docetaxel. However, there was difference in cross-resistance to 5-FU between these cell lines.
Cell Line* ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil ; Head and Neck Neoplasms* ; Head* ; Humans ; Paclitaxel ; Parents