Validation of the Korean version of the StandardizedCosmesis and Health Nasal Outcomes Survey / 대한이비인후과학회지

Background and Objectives@#The 10-item Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) is a recently developed questionnaire for assessing both nasal obstruction and nasal cosmetic satisfaction. It is widely used in rhinoplasty clinics based on its high level of reliability and efficacy in Western countries. In this study we evaluated the validity of the Korean version of the SCHNOS (K-SCHNOS).Subjects and Method The SCHNOS was translated into easily-understandable Korean following the guideline of the developers. Twenty-seven patients undergoing rhinoplasty and a control group of 29 non-rhinoplasty patients completed K-SCHNOS twice at intervals of 2 weeks regardless of pre- or postoperative state. The K-SCHNOS was evaluated for internal consistency, test-retest reliability, and validity. @*Results@#Of the 56 study participants, 39 (69.6%) were male and 17 (30.4%) were female, with the mean (standard deviation) age of 33.5 (12.9) years. Both obstructive domain and cosmetic domains showed high internal consistency with their respective Cronbach’α values being 0.92 and 0.91. The correlations in the test-retest analysis for each item were acceptable, ranging from 0.6-0.82. The association between the obstructive domain and cosmetic domain was 0.48 (95% confidence interval, 0.32-0.61), indicating a very weak correlation. @*Conclusion@#The K-SCHNOS has proven to be a reliable and valid questionnaire to be used by Korean-speaking patients undergoing functional or cosmetic rhinoplasty.

Comparison of the Effects of Middle Ear Implants and Conventional Hearing Aids on Cognitive Function / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The association between hearing impairment and cognitive function has been established in previous studies. The aim of this study was to compare the effects of conventional hearing aids and middle ear implants on cognitive function. SUBJECTS AND METHOD: This study included 22 participants who underwent middle ear implantation between October 2013 and September 2016. Their mean age at surgery was 70 years. Using Pure tone audiometry (PTA), the Speech discrimination test (SDT), and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, we compared audiologic benefits of three conditions [without hearing aids, with conventional hearing aids, or with Vibrant Sound bridge (VSB)]. Cognitive ability was evaluated using neuropsychological testings (Seoul Neuropsychological Screening Battery) at intervals of approximately eight weeks. RESULTS: The results of PTA showed a 7.96 dB HL gain with conventional hearing aids and a 10.00 dB HL gain with the use of VSB. SDT results showed a 4.10% gain with conventional hearing aids and a 10% gain with the use of VSB. Results of the APHAB questionnaire showed a significant increase with the use of VSB compared to conventional hearing aids. In the Korean Mini-Mental State Examination, a slight improvement was observed after middle ear implantation. In the Digit Span Test and Korean-Boston Naming Test, a significant improvement was seen with the use of VSB compared to conventional hearing aids. CONCLUSION: The use of middle ear implants in rehabilitation of hearing communication in patients showed improvements in cognitive abilities, compared to the use of conventional hearing aids.

A Case of Superior Semicircular Canal Dehiscence Syndrome with Coexisting Otosclerosis / 대한이비인후과학회지

Superior semicircular canal dehiscence (SSCD) syndrome and otosclerosis have overlapping clinical manifestations that can be difficult to distinguish. Audiovestibular symptoms are caused by noise or straining in SSCD, which is associated with the presence of an air-bone gap that overlaps with the characteristic of otosclerosis. We recently examined a 51-year-old woman presenting with unilateral pulsatile tinnitus and ipsilateral hearing loss in the left ear. Computerized tomography, audiometry and vestibular function test confirmed the diagnosis of ipsilateral SSCD syndrome with coexisting ipsilateral otosclerosis. The patient underwent surgical repair of dehiscence by middle fossa approach and stapes surgery for otosclerosis sequentially. She has not had pulsatile tinnitus postoperatively, and hearing improved with the closure of air-bone gap at most frequencies. In conclusion, when SSCD syndrome and otosclerosis coexist and patient has representative symptoms of both ear pathologies, a sequential surgery can be an effective treatment option.

Clinical Application of Hyperbaric Oxygen in Treatment of Idiopathic Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

Sudden sensorineural hearing loss is relatively common disease with unknown etiology. Although its etiology is unknown, it is thought to be a common pathway that leads to cochlear ischemia which leads to cochlear damage and hearing loss. Hyperbaric oxygen therapy is one of options for the treatment of sudden hearing loss which exposes patient with 1.5-3 fold sea level pressure of 100% oxygen which may reverse the ischemic condition of cochlea. According to previous studies, hyperbaric oxygen therapy is beneficial for restoring hearing level in sudden hearing loss patients especially when it is applied at early stage of onset, young age patient and profound hearing loss. Data from Asan medical center with 29 patients with idiopathic sudden sensorineural hearing loss shows 51.7% of good recovery rate after hyperbaric oxygen treatment. This treatment method however, also has minor complications and is very costly, practitioner should consider the cost-benefit before using this method.

Effectiveness of a Comprehensive Stress Management Program to Reduce Work-Related Stress in a Medium-Sized Enterprise

OBJECTIVES: To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management. METHODS: A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker's Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011. RESULTS: Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved. CONCLUSIONS: In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan.

High lead exposure in two leaded bronze ingot foundry workers

BACKGROUND: Awareness about lead poisoning in South Korea has increased; however, occupational exposures occurring in small-scale businesses have not been thoroughly investigated. We report two cases of high lead exposure in a leaded bronze ingot foundry. CASE PRESENTATION: Two employees, a 54-year-old primary operator and a 46-year-old assistant, at a small-scale metalworking company who had been employed for 18 years and 1 month, respectively, showed elevated blood lead levels (61.1 mug/dL and 51.7 mug/dL, respectively) at an occupational health checkup. Neither worker complained of abnormal symptoms nor signs related to lead poisoning. Health assessment follow-ups were conducted and biological exposure indices of lead were calculated every four weeks. After the initial follow-up assessment, both workers were relocated from the foundry process to the metalworking process. In addition, a localized exhaust system was installed after the second follow-up. CONCLUSIONS: Foundry workers in a small-scale businesses might be at high risk of lead exposure because these businesses might be vulnerable to poor industrial hygiene. Therefore, regular occupational health checkups are required.

In-vivo Optical Measurement of Neural Activity in the Brain

The optical neural recording techniques are promising tools in recent years. Compared to the traditional electrophysiological recording, the optical means offer several advantages including no inclusion of electrical noise, simultaneous imaging of a large number of neurons, or selective recording from genetically-targeted neurons. Overall the optical neural recording technique comprises the intrinsic and the extrinsic optical recordings. The methods for intrinsic neural recording employ the change of optical properties in brains such as blood flow/oxygenation, cellular volume change, or refractive index change without addition of external indicators. Those properties can be detected using various optical techniques including laser Doppler flowmetry (LDF), near-infrared (NIR) spectrometer, functional optical coherence tomography (fOCT), and surface plasmon resonance (SPR). The extrinsic monitoring techniques use fluorescence signals reflecting neuronal activity via chemical or genetic modification of the neuronal cells. Two most popular activity-dependent fluorescent probes, calcium indicators and voltage-sensitive fluorescent proteins will be examined in this review. The principles, the instrumentations and in vivo applications of those optical signal measurements are described.

The Prevalence of the Metabolic Syndrome and Cut-off Values of Power and Flexibility in Elderly Males / 대한스포츠의학회지

The purpose of the study was to find out the age-adjusted odds ratio of the metabolic syndrome and the associated cut-off values of the physical fitnessfactors of the elderly males in their 60s and 70s. 477 participants were tested for the cardiorespiratory fitness (VO2max), power, flexibility as well as blood battery and abdominal circumference for the metabolic syndrome status. As a result, 32.2% of the participants had metabolic syndrome with the associated cut-off values of the power and flexibility as 29.0 cm (areas under curve [AUC]: 0.57, p=0.029) and 0.6 cm (AUC: 0.54, p=0.028), respectively. The cardiorespiratory fitness showed no significant difference prevalence rate between groups. The prevalence rate was calculated by dividing the participants into high and low groups. The metabolic syndrome prevalence rate for the low power group was 1.63 (p<0.030) and low flexibility group was 2.01 (p<0.002). The cardiovascular fitness showed no significant prevalence rate.

Changes in transcript and protein levels of calbindin D28k, calretinin and parvalbumin, and numbers of neuronal populations expressing these proteins in an ischemia model of rat retina / 대한해부학회지

Excessive calcium is thought to be a critical step in various neurodegenerative processes including ischemia. Calbindin D28k (CB), calretinin (CR), and parvalbumin (PV), members of the EF-hand calcium-binding protein family, are thought to play a neuroprotective role in various pathologic conditions by serving as a buffer against excessive calcium. The expression of CB, PV and CR in the ischemic rat retina induced by increasing intraocular pressure was investigated at the transcript and protein levels, by means of the quantitative real-time reverse transcription-polymerase chain reaction, western blot and immunohistochemistry. The transcript and protein levels of CB, which is strongly expressed in the horizontal cells in both normal and affected retinas, were not changed significantly and the number of CB-expressing horizontal cells remained unchanged throughout the experimental period 8 weeks after ischemia/reperfusion injury. At both the transcript and protein levels, however, CR, which is strongly expressed in several types of amacrine, ganglion, and displaced amacrine cells in both normal and affected retinas, was decreased. CR-expressing ganglion cell number was particularly decreased in ischemic retinas. Similar to the CR, PV transcript and protein levels, and PV-expressing AII amacrine cell number were decreased. Interestingly, in ischemic retinas PV was transiently expressed in putative cone bipolar cell types possibly those that connect with AII amacrine cells via gap junctions. These results suggest that these three calcium binding proteins may play different neuroprotective roles in ischemic insult by their ability to buffer calcium in the rat retina.

Assessment of Mitral Blood Flow by Exercise Doppler Echocardiography in the Diagnosis of Coronary Artery Disease

BACKGROUND: The pattern of left ventricular filling as depicted by Doppler echocardiographic transmitrial flow velocities has been used to left ventricular diastolic properties. Especially, altered transmitral flow by abnormal myocardial wall motion and left ventricular function in ischemic heart disease, was predicted during exercise test. METHODS: To determine the effects of exercise on Doppler echocardiographic measures of left ventricular diastolic filling, we studied 15 angina pectoris patients and 20 normal control subjects. Transmitral flow measurements comprised peak and integrated early passive(E) and late atrial(A) filling velocities and diastolic filling period. RESULTS: Heart rate in negative exercise treadmill test group was 70/min at rest, 111/min just after exercise, and 86/min at 5 minutes after exercise. Positive exercise treadmill test group was 69/min, 109/min and 82/min, respectively. DFP and E duration were also significantly decreased after exercise in group with negative treadmill exercise test. In positive treadmill exercise group, peak A was significantly increased from 0.57+/-0.15m/sec to 0.75+/-0.20m/sec at just after exercise(p<0.01), 0.67+/-0.12m/sec at 5 minuties after exercise. DFP and E duration were also significantly decreased after exercise. CONCLUSION: Doppler echocardiographic transmitral flow was altered by abnormal regional wall motion and left ventricular dysfunction in ischemic heart disease during exercise test. The use of Doppler echocardiography for this purpose is limited, however, because a number of variables may influence transmitral flow patterns, including age, preload, afterload and systolic function.