The Objective Test of Cochlear Dead Region Using Acoustic Change Complex: A Preliminary Report / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cochlear dead region (CDR) is a region in the cochlear where hearing loss has occurred due to damage to the inner hair cells and/or neurons. Recently, a subjective test involving a pure-tone test in the presence of threshold-equalizing noise (TEN) was introduced to identify CDR. However, for uncooperative patients, such a subjective method would be unsuitable and objective methods would be needed instead to detect CDR. The acoustic change complex (ACC) is an evoked potential elicited by changes in the ongoing sound. In this study, we developed an objective method of identifying CDR by combining ACC response with a TEN test, namely the TEN-ACC test, and investigated its feasibility in normal-hearing listeners. SUBJECTS AND METHOD: Ten normal-hearing subjects participated in this study. All subjects underwent both behavioral TEN test and electrophysiological TEN-ACC test. The stimuli for the TEN-ACC test consisted of TEN and embedded pure tones with different frequencies/signals to noise ratios (SNRs). To identify the thresholds, the range SNR of stimulation was varied from 0 to 20 dB, in stages of 4 dB. RESULTS: The ACC responses of all subjects who participated in this study were well elicited by stimuli developed for the TEN-ACC test. We confirm that the pure-tones embedded in TEN elicited the objective ACC response. CONCLUSION: The results of this study suggest that the novel TEN-ACC test can be applied to evoke ACC in normal-hearing listeners. Future research should incorporate hearing-impaired listeners to determine the feasibility of the TEN-ACC test as an objective method to identify CDR.

Role of Interleukin-10-Expressing B Cells on the Pathophysiology of Chronic Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Many kinds of inflammatory cells and cytokines are suggested to be related with pathophysiology of chronic rhinosinusitis with nasal polyp (CRSwNP), but its mechanism is not yet fully understood. In particular, little is known about the function and role of Interleukin-10 (IL-10) producing regulatory B cells. The aim of this study was to investigate the presence and function of B cells, especially IL-10-producing regulatory B cells, in the nasal polyp (NP) and nasal mucosa. SUBJECTS AND METHOD: Twenty patients with CRSwNP, 10 patients with chronic rhinosinusitis without nasal polyp (CRSsNP) and 10 control subjects were enrolled in this study. NP tissues and uncinate tissues were collected for analysis. Real-time polymerase chain reaction (RT-PCR), immunohistochemistry were performed to measure the expression levels of the selected inflammatory cytokines and inflammation-associated molecules. RESULTS: In the mucosal tissues of CRSsNP patients, the number of IL-10+ B cells was significantly lower than that of NP and control mucosa of CRSwNP patients. The number of IL-10+ B cells was significantly increased in the eosinophilic NP, non-eosinohilic NP, CRSsNP, and control groups. There was a significant positive correlation between the number of IL-10+ B cells and B cell activating factor (BAFF). CONCLUSION: The expression of IL-10+ B cells and BAFF was significantly increased in CRSwNP patients compared to CRSsNP patients and control mucosal tissues, and IL-10+ B cells were more significantly increased in eosinophilic tissues. These results indicate that regulatory B cells are involved in the pathophysiology of eosinophilic NP and that BAFF contributes to the production of regulatory B cells.

Treatment of Tongue Cancer in Patient with Fanconi's Anemia / 대한이비인후과학회지

Fanconi's anemia is a rare autosomal recessive genetic disorder characterized by congenital abnormalities and anaplastic anemia. Patients with this disorder has predisposition for leukemia, specifically acute myeloid leukemia. Risk for head and neck solid tumors are also increased. Head and neck cancers in patients with Fanconi's anemia are significantly different from those in patients without Fanconi's anemia in frequency, distribution, clinical course, and treatment. Therefore, we report a case of 23-year-old male with Fanconi's anemia, who presented with an oral tongue cancer treated with radical excision, bilateral neck dissection and careful postoperative radiation therapy.

Effect of Nasal Septoturbinoplasty on Nasality or Acoustic Parameters / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the nasality and acoustic variables of control subjects and those of patients with deviated nasal septum (DNS), preoperatively and postoperatively. SUBJECTS AND METHOD: Twenty patients who underwent septoturbinoplasty (DNS group) and ten control subjects (control group) who did not complain of nasal obstruction or did not show any anatomic or pathologic abnormality were selected. Performed for these subjects were acoustic rhinometry, rhinomanometry, nasality test and long-term average spectrum analysis of nasal sound sentence. Data were collected and analyzed prior to and 4 weeks after the surgery. RESULTS: In DNS group, the volume of nasal cavity was significantly increased and the nasal resistance was decreased significantly after operation. There were no statistically significant differences in the nasality of all sentences in the DNS group compared to those in the preoperative and the postoperative group. However, alternations of several acoustic variables in the final consonant were detected. CONCLUSION: Alternation of nasality and acoustic variables was observed after septoturbinoplasty, however, the changes of nasal resistance have been shown to contribute to the results.

Benefit From Directional Microphone Hearing Aids: Objective and Subjective Evaluations

OBJECTIVES: The aims of this study were to find and compare the effect of directional (DIR) processing of two different hearing aids via both subjective and objective methods, to determine the association between the results of the subjective and objective evaluations, and to find out individual predictive factors influencing the DIR benefit. METHODS: Twenty-six hearing aid users fitted unilaterally with each two different experimental hearing aid performed modified Korean Hearing in Noise Test (K-HINT) in three DIR conditions; omnidirectional (OMNI) mode, OMNI plus noise reduction feature, fixed DIR mode. In order to determine benefits from DIR benefit within a hearing aid and compare performance of the DIR processing between hearing aids, a subjective questionnaire was administrated on speech quality (SQ) and discomfort in noise (DN) domain. Correlation analysis of factors influencing DIR benefit was accomplished. RESULTS: Benefits from switching OMNI mode to DIR mode within both hearing aids in K-HINT were about 2.8 (standard deviation, 3.5) and 2.1 dB SNR (signal to ratio; SD, 2.5), but significant difference in K-HINT results between OMNI and OMNI plus noise reduction algorithm was not shown. The subjective evaluation resulted in the better SQ and DN scores in DIR mode than those in OMNI mode. However, the difference of scores on both SQ and DN between the two hearing aids with DIR mode was not statistically significant. Any individual factors did not significantly affect subjective and objective DIR benefits. CONCLUSION: DIR benefit was found not only in the objective measurement performed in the laboratory but also in the subjective questionnaires, but the subjective results was failed to have significant correlation with the DIR benefit obtained in the K-HINT. Factors influencing individual variation in perceptual DIR benefit were still hard to explain.

Effect of Microalgal Extracts of Tetraselmis suecica against UVB-Induced Photoaging in Human Skin Fibroblasts

Exposure of cells to ultraviolet B (UVB) radiation can induce production of free radicals and reactive oxygen species (ROS), which damage cellular components. In addition, these agents can stimulate the expression of matrix metalloproteinase (MMP) and decrease collagen synthesis in human skin cells. In this study, we examined the anti-photoaging effects of extracts of Tetraselmis suecica (W-TS). W-TS showed the strongest scavenging activity against 2,2-difenyl-1-picrylhydrazyl (DPPH) and peroxyl radicals, followed by superoxide anions from the xanthine/xanthine oxidase system. We observed that the levels of both intracellular ROS and lipid peroxidation significantly increased in UVB-irradiated human skin fibroblast cells. Furthermore, the activities of enzymatic antioxidants (e.g., superoxide dismutase) and the levels of non-enzymatic antioxidants (e.g., glutathione) significantly decreased in cells. However, W-TS pretreatment, at the maximum tested concentration, significantly decreased intracellular ROS and malondialdehyde (MDA) levels, and increased superoxide dismutase and glutathione levels in the cells. At this same concentration, W-TS did not show cytotoxicity. Type 1 procollagen and MMP-1 released were quantified using RT-PCR techniques. The results showed that W-TS protected type 1 procollagen against UVB-induced depletion in fibroblast cells in a dose-dependent manner via inhibition of UVB-induced MMP-1. Taken together, the results of the study suggest that W-TS effectively inhibits UVB-induced photoaging in skin fibroblasts by its strong anti-oxidant ability.

A case of gastritis cystica profunda with early gastric cancer / 대한내과학회지

We report a rare case of adenocarcinoma with multiple gastritis cystica profunda that develope in a 56-year-old man. We found early gastric cancer at the gastric angle. And some cystic lesion was present at lesser curvature of the body. Gastrectomy was performed for confirmation and treatment. Gastritis cystica profunda (GCP) is usually characterized by multiple cystic mass in the mucosa and submucosa of the stomach. It is rare disease which is mainly found at the stoma site of gastroenterostomy. Occasionally GCP develops in the stomach without previous history of surgery. Most common feature of GCP is sessile polypoid protrusion but, submucosal tumor, giant gastric mucosal fold and pedunculated mass are found. Some evidence suggests that downward adenocystic proliferation of glands is a dysplastic or precancerous change. But we know that these submucosal cystic lesion may not be precancerous. Thus cystic mass must be distinguished from Menetrier's disease, Zollinger-Eillison's syndrome, and other malignancy.

The Expression of Melanoma-Antigen Gene A1-6 during the Carcinogenesis of the Colon / 대한소화기내시경학회지

BACKGROUND/AIMS: Melanoma antigen gene (MAGE)-A which have more than 12 subtypes is a gene family for tumor specific shared antigens, recognized by the cytotoxic T cell. Since these genes are expressed only in tumor cells and silent in normal adult tissues except in the male germ line, they may be used as diagnostic markers in detecting malignancy. During the carcinogenesis of gastrointestinal tract, the hyperplastic epithelium-adenoma-adenocarcinoma sequence is largely accepted and the molecular studies on each step have been issued. However, in the aspect of carcinogenesis in the gastrointestinal tract, MAGE genes have not studied yet. To explore the functional role and clinical significance of MAGE-A genes in the carcinogenesis of the colon, mRNA expression of MAGE-A1 to -A6 in the mucosal tissues obtained from the colonoscopy was investigated and the relationship between their expressions and clinicopathologic parameters was analysed. METHODS: We investigated the expression of MAGE 1~6 in 65 endoscopically biopsied samples of neoplastic and nonneoplastic tissues from the colon, using a MAGE common primer by the reverse transcription-nested polymerase chain reaction and DNA sequencing. RESULTS: Of the 31 colorectal adenocarcinoma specimens examined, MAGE genes were expressed in 11 cases (36%). In contrast, no expression of these genes was observed in any of the 12 samples of tubular adenoma and 12 of non-specific colitis and 5 cases of normal colonic tissues. There was no significant correlation between the expression of the MAGE genes and clinicopathologic factors, such as gender, disease stage, lymph node metastasis and perineural and vascular invasion in colonic carcinoma. CONCLUSIONS: It is postulated that the expression of MAGE genes could reflect the late event of oncogenesis of the colon because no MAGE expression was noticed in chronic inflamamtion and adenomas which might have the important role in the process of malignant transformation.

A Case of Endoscopic Treatment of Bleeding in Duodenal Dieulafoy's Lesion / 대한소화기내시경학회지

Dieulafoy's lesions are often unrecognized cause of obscure, massive gastrointestinal bleeding, reported to be 0.3~1.5% of cases of major gastrointestinal bleeding. It is characterized by severe bleeding from rupture of an exposed submucosal artery. Dieulafoy's lesion is usually occured in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction. Similar lesions have also been described in the esophagus, duodenum, small intestine, colon, and rectum. The diagnosis is made by endoscopy, angiography, laparoscopy, or laparotomy. Endoscopy showed protruding and eroded artery with pulsatile bleeding or adherent thrombus. Currently, various therapeutic options are available to the endoscopist for the treatment of Dieulafoy's lesions. Therapeutic endoscopy should now become first-line therapy for Dieulafoy's lesions. We experienced a rare case of bleeding from the duodenal Dieulafoy's lesion. Endoscopic hemoclipping was performed successfully. We report this case with a review of the literature.

A Case of a Solitary Peutz-Jeghers Type Hamartomatous Polyp in the Duodenum with Upper Gastrointestinal Bleeding as the Initial Diagnosis / 대한소화기내시경학회지

Peutz-Jeghers syndrome is a genetic disorder consisting of mucocutaneous pigmentation and gastrointestinal polyposis. Although the polyp may be found in a solitary fashion in this syndrome, such a case is exceedingly rare and would result in a case report even in other countries. A solitary Peutz-Jeghers polyp had not been reported domestically until now, and thereby, the authors here present a case of a clinical experience of Peutz-Jeghers syndrome with a solitary hamartomatous polyp in the duodenum.

Study of Prostatic Disease and Symptom between Special Occupation Groups(Taxi Driver, Barber) / 대한비뇨기과학회지

PURPOSE: To compare symptoms of prostatism and their causes between two occupation groups with different working environment and position: one group of tarsi drivers working mainly in sitting position under constant stress and another group of barbers working mainly in standing position. MATERIALS AND METHOD: 405 taxi drivers and 110 barber participated in prostatic disease screening program. 93 patients with prostatic symptom were also enrolled in this study. All participants underwent IPSS self-assessment, digital rectal examination, urinary flow rate, transrectal ultrasound and prostatic cancer screening test (PSA, and if necessary, prostatic biopsy). RESULTS: IPSS were similar in taxi drivers group and patient group, whereas it was significantly lower in barbers group. Mean maximal flow rate was similar in both taxi drivers and patient groups, but significantly higher in barbers group. Incidence of abnormal voiding pattern was significantly higher in taxi drivers group compared to other groups. TRUS showed higher incidence of calcification and ejaculatory duct abnormality in taxi drivers group compared to other groups. Prostatitis and prostatodynia combined were more prevalent in taxi drivers group than in barbers groups. CONCLUSIONS: Taxi drivers working in a constrained environment of prolonged sitting exposed to a lot of stress, pelvic floor tension and abstinence of urine had more diverse voiding symptoms and greater prevalence of prostatitis and prostatodynia than barbers group.

Sexual Dysfunction in Diabetic Patients / 대한비뇨기과학회지

Erectile failure is a common complication of diabetes mellitus. We evaluate 2l male diabetic patients with erectile failure. Evaluation was done by CBC,SMA-12, Penile digital systolic pressure index(PDI), Bulbocavernous reflex latency time (BCRL) and serum testosterone and prolactin levels. All of the patients showed normal serum testosterone and prolactin levels. Of 21 patients, only 1 patient showed decreased PDI who also prolonged BCRL. And 12 patients (57%) were showed prolonged BCRL without decreased PDI. This study suggests that penile neuropathy is the most prevalent abnormality in diabetics with erectile failure and may predate vascular abnormalities.

Diagnostic Value of Penile-Digital Systolic Pressure index (PDI) in Arteriogenic lmpotence: A study for normal values in Korean males / 대한비뇨기과학회지

Penile and digital systolic pressures were measured with Doppler ultrasonic sthetoscope in 65 normal subjects. This technique is simple, reliable, inexpensive OPD procedure for the detection of penile arterial lesion in patients with impotence. With this study, we concluded that normal men have a PDI ratio above 0.77, and impotent men have a. PDI ratio below 0.63. However, the ratio range from 0.63 to 0.77 is borderline range which is not clearly impotent or normal. Hyperemic stress test is indicated the patient with borderline range. Pelvic steal test can detect vascular pathological condition previously missed by PDI. We indicate this test in the patients with history of intermittent gluteal claudication. We concluded that arteriogenic impotence is easily diagnosed by PDI combined with hyperemic stress test and pelvic steal test, if indicated.

Bilateral Congenital megacalicosis: A Case Report / 대한비뇨기과학회지

Megacalicosis is a primary disease of renal calyces which were dilated without evidence of obstruction. Since its first description by Puigvert in 1963, megacalicosis has been described in many literatures. Recently we experienced a case of bilateral congenital megacalicosis with right lower ureteral obstruction. Herein we report our case with brief review of literatures.

Epidermoid Cyst of Testis: Case Reports / 대한비뇨기과학회지

The average incidence of testicular tumor is approximately 2-3 per 100,000 male subjects. Benign tumors of the testis are rare, accounting for less than 1 percent of all testicular tumors. Herein we reported 2 cases of epidermoid cyst of the testis and review the literatures.

Nonfunctioning Adrenal Cortical Carcinoma: A Case Report / 대한비뇨기과학회지

Nonfunctioning adrenal cortical carcinoma is extremely rare, which probably merely secreted insufficient steroid to cause signs and symptoms. We experienced a case of nonfunctioning adrenal cortical carcinoma without metastatic evidence, treated by only adrenalectomy.

Duplicated Ureters: 2 Cases Treated with Ipsilateral Ureteroureterostomy (end-to-side anastomosis) / 대한비뇨기과학회지

Duplication of renal pelvis and ureter is the most common congenital anomaly of that upper urinary tact. The three most important abnormalities associated with duplex kidneys are V-U reflux, ectopic ureter and ureterocele. There is no single method of treating V-U reflux with complete ureteric duplication which will apply to all cases. With reflux, the pole segment of duplicated kidney may be severly diseased and must be removed by partial nephroureterectomy. Another surgical approach to the problem of reflux in duplicated ureters is "common sheath" reimplantation generally. But there are high risk of injuries to pelvic viscera and vasculatures. We performed ipsilateral ureteroureterostomy (end-to-side anastomosis) using microsurgery for another alternative method. We found there are no risk of injuries to the pelvic viscera anti vasculatures, the procedure is very simple and the result is very excellent. Herein we report our cases with brief review of literatures.

Milk of Calcium in Renal Caliceal Diverticulum / 대한비뇨기과학회지

A Milk of calcium is a well known finding in the extrahepatic biliary tree, particulary in the gallbladder, but rarely occurred in the kidneys. A caliceal diverticulum is a saccular structure containing urine and connect to an adjacent calyx by a narrow isthmus. They are lined with transitional epithelium continuous with that of calyx. Their origin is still unknown, but is generally attributes either to a developmental malformation or to prior infection. The diagnostic appearance may be lacking when the condition is present, since an errect or decubitus projection is frequently not a standard part of each roentgenologic examination of the abdomen or urinary tract. The management and treatment of Milk of Calcium in renal caliceal diverticulum is based on subjective and objective findings. Surgery should consist of eradication of the diverticulum lining and obliteration of communicating channel. We explored the kidney for the impression of renal stone, but could not find the stone, Retrospective review turned out to be the Milk of Calcium. We report our experience here in with review of literatures.