Successful treatment of sensorineural hearing loss in Sjögren's syndrome with corticosteroid

No abstract available.

A Prospective, Randomized Comparison of Promus Everolimus-Eluting and TAXUS Liberte Paclitaxel-Eluting Stent Systems in Patients with Coronary Artery Disease Eligible for Percutaneous Coronary Intervention: The PROMISE Study

We aimed comparing two-year clinical outcomes of the Everolimus-Eluting Promus and Paclitaxel-Eluting TAXUS Liberte stents used in routine clinical practice. Patients with objective evidence of ischemia and coronary artery disease eligible for PCI were prospectively randomized to everolimus-eluting stent (EES) or paclitaxel-eluting stent (PES) groups. The primary end-point was ischemia-driven target vessel revascularization (TVR) at 2 yr after intervention, and the secondary end-point was a major adverse cardiac event (MACE), such as death, myocardial infarction (MI), target lesion revascularization (TLR), TVR or stent thrombosis. A total of 850 patients with 1,039 lesions was randomized to the EES (n=425) and PES (n=425) groups. Ischemic-driven TVR at 2 yr was 3.8% in the PES and 1.2% in the EES group (P for non-inferiority=0.021). MACE rates were significantly different; 5.6% in PES and 2.5% in EES (P = 0.027). Rates of MI (0.8% in PES vs 0.2% in EES, P = 0.308), all deaths (1.5% in PES vs 1.2% in EES, P = 0.739) and stent thrombosis (0.3% in PES vs 0.7% in EES, P = 0.325) were similar. The clinical outcomes of EES are superior to PES, mainly due to a reduction in the rate of ischemia-driven TVR.

Typology of ROII Patterns on Cluster Analysis in Korean Enterprises

OBJECTIVES: Authors investigated the pattern of the rate of occupational injuries and illnesses (ROII) at the level of enterprises in order to build a network for exchange of experience and knowledge, which would contribute to workers' safety and health through safety climate of workplace. METHODS: Occupational accidents were analyzed at the manufacturing work site unit. A two step clustering process for the past patterns regarding the ROII from 2001 to 2009 was investigated. The ROII patterns were categorized based on regression analysis and the patterns were further divided according to the subtle changes with Mahalanobis distance and Ward's linkage. RESULTS: The first clustering of ROII through regression analysis showed 5 different functions; 29 work sites of the linear function, 50 sites of the quadratic function, 95 sites of the logarithm function, 62 sites of the exponential function, and 54 sites of the sine function. Fourteen clusters were created in the second clustering. There were 3 clusters in each function categorized in the first clustering except for sine function. Each cluster consisted of the work sites with similar ROII patterns, which had unique characteristics. CONCLUSION: The five different patterns of ROII suggest that tailored management activities should be applied to every work site. Based on these differences, the authors selected exemplary work sites and built a network to help the work sites to share information on safety climate and accident prevention measures. The causes of different patterns of ROII, building network and evaluation of this management model should be evaluated as future researches.

Typology of ROII Patterns on Cluster Analysis in Korean Enterprises

OBJECTIVES: Authors investigated the pattern of the rate of occupational injuries and illnesses (ROII) at the level of enterprises in order to build a network for exchange of experience and knowledge, which would contribute to workers' safety and health through safety climate of workplace. METHODS: Occupational accidents were analyzed at the manufacturing work site unit. A two step clustering process for the past patterns regarding the ROII from 2001 to 2009 was investigated. The ROII patterns were categorized based on regression analysis and the patterns were further divided according to the subtle changes with Mahalanobis distance and Ward's linkage. RESULTS: The first clustering of ROII through regression analysis showed 5 different functions; 29 work sites of the linear function, 50 sites of the quadratic function, 95 sites of the logarithm function, 62 sites of the exponential function, and 54 sites of the sine function. Fourteen clusters were created in the second clustering. There were 3 clusters in each function categorized in the first clustering except for sine function. Each cluster consisted of the work sites with similar ROII patterns, which had unique characteristics. CONCLUSION: The five different patterns of ROII suggest that tailored management activities should be applied to every work site. Based on these differences, the authors selected exemplary work sites and built a network to help the work sites to share information on safety climate and accident prevention measures. The causes of different patterns of ROII, building network and evaluation of this management model should be evaluated as future researches.

A Case of Actinomycosis of the Maxillary Sinus Accompanied with Fungal Ball

Actinomycosis of the paranasal sinuses is rare and usually arises from the oral cavity after a dental procedure or trauma. Actinomycosis of the maxillary sinus is very rare and found only in isolated case reports. We report the case of a 62-year-old patient with actinomycosis accompanied by a fungal ball in the maxillary sinus.

Beneficial Effect of Efonidipine, an L- and T-Type Dual Calcium Channel Blocker, on Heart Rate and Blood Pressure in Patients With Mild-to-Moderate Essential Hypertension

BACKGROUND AND OBJECTIVES: Efonidipine hydrochloride, an L- and T-type dual calcium channel blocker, is suggested to have a heart rate (HR)-slowing action in addition to a blood pressure (BP)-lowering effect. The aim of this study was to determine the effect of efonidipine on HR and BP in patients with mild-to-moderate hypertension. SUBJECTS AND METHODS: In a multi-center, prospective, open-labeled, single-armed study, we enrolled 53 patients who had mild-to-moderate hypertension {sitting diastolic BP (SiDBP) 90-110 mmHg}. After a 2-week washout, eligible patients were treated with efonidipine (40 mg once daily for 12 weeks). The primary end point was the change in HR from baseline to week 12. The secondary end-point included the change in trough sitting BP and 24-hour mean BP between baseline and week 12. Laboratory and clinical adverse events were monitored at each study visit (4, 8, and 12 weeks). RESULTS: Fifty-two patients were included in the intention-to-treat analysis. After 12 weeks of treatment with efonidipine, the resting HR decreased significantly from baseline to week 12 {from 81.5+/-5.3 to 71.8+/-9.9 beats/minute (difference, -9.9+/-9.0 beats/minute), p<0.0001}. The trough BP {sitting systolic blood pressure (SiSBP) and SiDBP} and 24-hour mean BP also decreased significantly (SiSBP: from 144.6+/-8.2 to 132.9+/-13.5 mmHg, p<0.0001; SiDBP: from 96.9+/-5.4 to 88.3+/-8.6 mmHg, p<0.0001, 24-hour mean systolic BP: from 140.4+/-13.5 to 133.8+/-11.6 mmHg, p<0.0001; 24-hour mean diastolic BP: from 91.7+/-8.7 to 87.5+/-9.5 mmHg, p<0.0001). CONCLUSION: Efonidipine was effective in controlling both HR and BP in patients with mild-to-moderate hypertension.

A Case of Sialectasis of Stensen's Duct / 대한이비인후과학회지

Sialectasis of Stensen's duct is a rare disease that is characterized by abnormal dilatation of the duct. The underlying pathology in this condition is obscure, but ductal dilation most commonly occurs as a consequence of ductal stenosis or narrowing. In this report, a rare case of sialectasis of Stensen's duct confirmed by radiologic study is presented with a review of the literature.

A Case of Laryngeal Amyloidosis / 대한이비인후과학회지

Amyloidosis is not a single entity but rather a group of diseases characterized by the presence of extracelluar deposition of insoluble, fibrillar, proteinaceous material with a well-defined, beta-pleated sheet ultrastructure, mainly in tissues derived from the mesoderm. Approximately 9% to 15% of amyloid tumors are localized. The larynx is the most usually involved site in the head and neck. It is estimated that less than 1% of the benign tumors is found in the larynx. We report a case of laryngeal amyloidosis with a review of its clinical patterns, diagnostic tools, pathologic findings and treatments.

Effect of Adenotonsillectomy on Inattention and Hyperactivity in Children with Sleep Disordered Breathing / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sleep disordered breathing (SDB) is a common problem in otolaryngology and comprises a spectrum of airway disorders that ranges from simple snoring to obstructive sleep apnea. SDB can exhibit problems of behavioral regulation such as inattention, hyperactivity and impulsivity. We aim to assess the effect of adenotonsillectomy on inattention and hyperactivity before and after adenotonsillectomy in children with SDB. SUBJECTS AND METHOD: We selected 19 pediatric patients with SDB, whose tonsils are of grade III or greater and the adenoid-nasopharyngeal ratio was 70% or more. The degree of inattentiveness and hyperactivity was evaluated by ADHD diagnostic system (ADS), trail making test, Wisconsin card sorting test (WCST) and SNAP-IV rating scale. RESULTS: There was significant improvement after adenotonsillectomy in the score of auditory ADS, trail making test, WCST, SNAP-IV rating scale. However, no improvement in postoperative visual ADS was observed. CONCLUSION: Adenotonsillectomy could be recommended to improve inattentiveness and hyperactivity in children with SDB.

A Case of Lymphoepithelial Cyst of Palatine Tonsil / 대한이비인후과학회지

Lymphoepithelial cysts of the oral cavity are rare lesions. The incidence when the number of lymphoepithelial cysts was compared to the total number of oral biopsies was 0.09 percent. Especially, the number of lymphoepithelial cysts originated from palatine tonsil was very small. They have been reported as branchial cleft cysts, branchiogenic cysts and pseudocysts because microscopically resemble each other. The lesions present as a small, well circumscribed, yellowish elevated nodule lined with stratified squamous epithelium surrounded by lymphoid tissue, usually on the floor of the mouth or the ventral or posterolateral surface of the tongue. Less frequent locations include the soft palate, mandibular vestibule, anterior pillar, and retromolar pad. We present a case report of a patient with an lymphoepithelial cyst in the right palatine tonsil presenting with throat discomfort.

A Case of Incus Dislocation into the External Auditory Canal after Head Trauma / 대한이비인후과학회지

Temporal bone fracture is usually the result of blunt head injury as ossicular disruption or isolated dislocation of individual ossicles may occur after temporal bone trauma. The incus is particularly prone to displacement because of its fragile ligamentous support. We report a rare case of incus dislocation into the external auditory canal associated with an underlying temporal bone fracture.

A Case of Osteoma in the Nasal Cavity / 대한이비인후과학회지

Osteoma is a slow-growing benign tumor composed of mature bone. Osteoma of the nose and paranasal sinuses is usually asymptomatic and most commonly occurs in the frontal sinus, followed by the ethmoidal and maxillary sinus. The occurrence in the sphenoidal sinus and nasal cavity is very rare. We present a case report of a patient with an isolated osteoma in the right nasal cavity presenting with nasal obstruction.

The Effect of the Anatomical Changes in Nasal Cavity and Nasopharynx on the Pressure of Paranasal Sinuses and Ventilation of Maxillary Sinus in Model Experiment / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Anatomical alterations of sinonasal cavity produced by various sinonasal diseases and surgeries can cause too much or too little sinus ventilation, which may develop pathology in the sinus. We studied the effect of the anatomical changes in nasal cavity and nasopharynx on the pressure of paranasal sinuses and ventilation of maxillary sinus in model experiment. MATERIALS AND METHOD: Anatomically accurate laboratory sinonasal model was constructed from computerized axial tomography scans of a healthy male. The pressure changes in the paranasal sinuses and oxygen washout from the maxillary sinus were investigated during controlled respiration by volunteer via corrugated tube connected to the nasopharynx of the normal model. The same procedures were performed in the adenoid hypertrophy and ethmoidectomized models. RESULTS: Adenoid hypertrophy caused an increase in maxillary antral pressure amplitude (the difference between peak positive and negative pressure), but showed a decrease in ventilation. In the ethmoidectomized model, ethmoidectomy improved maxillary sinus ventilation with slight decrease in the antral pressure amplitude, and widening of the ostium significantly increased ventilation, whereas near total middle turbinectomy impaired ventilation. CONCLUSION: The results obtained with the present model experiment may be of use for the understanding of the relations between anatomical change in the sinonasal cavity and sinus ventilation.

A Case of Spindle Cell Carcinoma Accompanied by Inverted Papilloma / 대한이비인후과학회지

Spindle cell carcinoma (sarcomatoid carcinoma) of the upper aerodigestive tract is a rare malignant neoplasm and can be misdiagnosed as reactive lesion or mesenchymal lesion. Spindle cell carcinoma is found predominantly in the larynx and pharynx, but they also occur in the sinonasal tract, oral cavity, and esophagus. The best diagnostic tool of spindle cell carcinoma is immunohistologic staining. Spindle cell reacts positively with cytokeratin and vimentin, but reacts negatively with desmin, smooth muscle actin, collagenIV and s-100 protein. Squamous cell carcinoma is the major malignancy that is associated with inverted carcinoma. To our knowledge, this is the first case report of spindle cell carcinoma accompanied by inverted papilloma, and we represent the case with a review of the related literatures.

A Case of Conductive Hearing Loss by Heterotopic Neuroglial Tissue in the Middle Ear / 대한이비인후과학회지

Heterotopic brain tissue is defined as displaced neuroglial tissue that has no connection with the central nervous system. Mostly it involves the midline structures including nose, nasopharynx, oropharynx, palate, lips tongue, and tonsil. Rarely it involves non-midline structures such as middle ear, mastoid, and orbit. Commonly accepted theory is that heterotopic neural tissue is a variant of encephalocele in which the central nervous system connection has been lost or became vestigial. We experienced a case of heterotopic neuroglial tissue found in a patient who had conductive hearing loss in unilateral ear, and report it with a review of the related literature.

A Case of Submental Lymphadenitis by Toxoplasmosis / 대한이비인후과학회지

Toxoplasma gondii, an intracellular coccidian protozoan and a widespread parasite affecting various animals and humans, is one of the common causes of cervical lymphadenitis in human. Cervical lymphadenitis is the most common clinical manifestation of toxoplasmosis in an immunocompetent host, but still more rare in Korea than in other countries, including United States and Europe. In Korea, number of travelers to and from other countries and inclusion of meat as a part of daily diet are increasing, possibly increasing the incidence of toxoplasma lymphadenitis, which should be considered by differential diagnosis of lymphadenitis. We present a case of toxoplasma lymphadenitis in submental lymph nodes in an immunocompetent host.

A Case of Chondrodysplasia Punctata Combined with Unilateral Choanal Atresia / 대한이비인후과학회지

Chondrodysplasia punctata is a rare congenital disease. It is classified into four main types according to the clinical features and heredity: autosomal dominant (Conradi-Hunermann's) type, autosomal recessive (rhizomelic) type, X-linked dominant type and X-linked recessive type. Among the four, rhizomelic chondrodysplasia punctata (RCDP) is the most lethal form of the disease, and most patients die in the neonatal period. Diagnosis of the RCDP relies on its characteristic features and radiological finding. The characteristic features are craniofacial dysmorphism (flat face, flat nasal bridge, anteverted nostril, telecanthus), cataracts, rhizomelic limb shortening, ichthyosis, and mental retardation. Radiologic findings include rhizomelic symmetrical shortening of upper or lower extremity, coronal cleft of vertebral body, metaphysical spraying and stippled calcification. This case shows typical abnormality in the face and extremity and also radiologic abnormality, uniquely combined with unilateral choanal atresia.

A Case of Acquired Transient Laryngomalacia Associated with Diabetic Ketoacidosis / 대한이비인후과학회지

Collapse of epiglottis during inspiration is an unusual cause of upper airway obstruction. It is usually classified as a congenital anomaly but several acquired cases have been reported to occur in patients who have lost pharyngeal airway support by head injury and coma. Recently, we experienced a case of laryngomalacia that was associated with diabetic ketoacidosis and compromised the airway. A tracheotomy was first needed to maintain the respiration, then conservative management including diabetes control was enough to restore the patient's condition. This case supports the neuromuscular dysfunction theory which purports laryngomalacia as its cause.

A Case of Kartagener's syndrome combined with congenital nystagmus / 대한이비인후과학회지

Primary ciliary dyskinesia results in characteristic clinical symptoms, including chronic pansinusitis, recurrent infections of the respiratory tract, and infertility. Kartagener's syndrome is clinically distinguishable by the presence of situs inversus from this group of diseases. Other otolaryngological manifestations of primary ciliary dyskinesia which have been reported include otitis media with effusion, tympanosclerosis, keratosis obturans, and chronic cholesteatoma. Congenital nystagmus is another otological symptom characterized by ocular oscillation, which usually appears in the early infancy, and is often associated with visuosensory abnormalities. Recently, we experienced a 13 year-old boy with congenital nystagmus in addition to all other manifestations of Kartagener's syndrome. Although the clinical implication is not clear, it is possible that two diseases share the same developmental abnormality.

A Case of Esophageal Foreign Body Causing Unilateral Vocal Cord Paralysis / 대한이비인후과학회지

Foreign bodies in the upper aerodigestive tract are one of the most frequently encountered accidental cases in the otolaryngological fields, and may cause severe complications such as esophageal ulceration, esophageal perforation, periesophagitis, tracheoesophageal fistula, mediastinitis, pneumothorax and pyothorax. Therefore, speedy diagnosis and early intervention is needed to reduce morbidity and mortality. Recently, we experienced a rare case of esophageal foreign body which caused unilateral vocal cord paralysis. We report this case with a review of literature.