Difference Between the Preferred Gain and the NAL-NL2 Gain in Korean Hearing Aid Users / 대한이비인후과학회지

Background and Objectives@#The purpose of this study was to compare the preferred gain and the National Acoustic Laboratories Nonlinear 2nd edition (NAL-NL2) gain value in Korean language hearing aid users.Subjects and Method In this retrospective study, preferred gain and NAL-NL2 gain data were obtained from 199 monaural hearing aids users who were satisfied with their hearing aid devices. The gain value data were collected from three different sound levels at various frequencies. Several factors were also evaluated to determine a potential impact on the preferred gain. @*Results@#The preferred gain was significantly higher than the NAL-NL2 target gain (p=0.01). This difference was highest with the gain measured with a medium-level sound (65 dB) with 1 kHz tone. There was a tendency of reduced preferred gain with the increased age of the participant (p=0.049). @*Conclusion@#The results indicate that Korean hearing aid users require more gain than the NAL-NL2 target gain. Linguistic characteristics, age, degree of hearing loss, and many other factors may be implicated in this result.

Sleep Disorder in Tinnitus Patients / 대한이비인후과학회지

Background and Objectives@#One of the most common complaint of tinnitus patients has been sleep disorder. The aim of this study was to evaluate the relationship between sleep disorder and tinnitus.Subjects and Method Patients with tinnitus from July 2018 till August 2019 were enrolled. Subjects who had any acute/chronic disease in the inner and middle ear or external auditory canal, sleep apnea and had more than 3 caffeinated beverages a day was excluded. Study participants completed Beck Depression Inventory (BDI), the tinnitus symptom questionnaire, tinnitus handicap inventory (THI), Pittsburg Sleep Quality Inventory (PSQI), pure tone audiometry, a full otologic examination and an interview on past medical history. @*Results@#THI was correlated with PSQI global score and BDI. The PSQI subscale most relevant to THI was PSQI 1 (subjective sleep quality). Hearing impairment was correlated with the THI functional subscale. BDI was individually related to PSQI. @*Conclusion@#Tinnitus is found to be highly related to sleep disorder, suggesting a common pathway of aggravation and treatment target. Tinnitus is also more affected by sleep disorder than by depression. A further examination and treatment of comorbid sleep disorder in tinnitus patients is recommended.

Comparison of Functional Outcomes after PoweredIntracapsular Tonsillectomy with Adenoidectomy andConventional Extracapsular Tonsillectomy withAdenoidectomy for Pediatric Obstructive Sleep Apnea / 대한이비인후과학회지

Background and Objectives@#This study was investigated to compare the clinical outcomes and complications of powered intracapsular tonsillectomy and adenoidectomy (PITA) with those of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment of pediatric obstructive sleep apnea (OSA).Subjects and Method Eighty-one children with adenotonsillar hyperplasia underwent tonsillectomy and adenoidectomy (46 PITA and 35 ECTA) from December 2016 to July 2017 for OSA. The choice of surgical procedure (PITA vs. ECTA) was determined by the number of episodes of acute tonsillitis. The quality of life measurement was performed using Korean Obstructive Sleep Apnea Survey (KOSA-18) score. Postoperative bleeding was assessed as number of revisit or readmission. Postoperative pain was evaluated by visual analog scale (VAS) at postoperative day 1, 3, and 7. @*Results@#PITA and ECTA significantly reduced KOSA-18 scores postoperatively (p＜0.01, p＜0.01, respectively) and were equally effective in pediatric OSA treatment. Postoperative bleeding was lower in the PITA group, but there was no statistical difference due to small number of cases. VAS score for postoperative pain was significantly lower in the PITA group at day 1, 3, and 7 (p=0.03, p＜0.01, and p＜0.01, respectively). @*Conclusion@#PITA is effective in pediatric OSA treatment with less morbidity, and less complications.

The Study of Standardization for a Korean Dizziness Handicap Inventory for Patient Caregivers / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index. SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability. RESULTS: By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations. CONCLUSION: The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.

The Study of Standardization for a Korean Dizziness Handicap Inventory for Patient Caregivers / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index.SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability.@*RESULTS@#By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations.@*CONCLUSION@#The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.

Study on Assessment and Treatment Patterns of Speech-Language Pathologists in Pediatric Vocal Problem Through Multicenter Survey

BACKGROUND AND OBJECTIVES: Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. MATERIALS AND METHOD: An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. RESULTS: Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pre-treatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. CONCLUSION: Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

The Factors Affecting Recurrence of Symptoms after Infrainguinal Arterial Endovascular Angioplasty

BACKGROUND: This study reports the result of endovascular treatment for arterial occlusive disease limited to femoropopliteal lesions, focusing on the recurrence of symptoms instead of patency. METHODS: This was a retrospective, single-center study. From April 2007 to November 2011, 48 limbs in 38 patients underwent endovascular stenting or balloon angioplasty to treat femoropopliteal arterial occlusive disease. The factors affecting the recurrence of symptoms were analyzed. RESULTS: The mean age of the patients was 69.60+/-7.62 years. Among the baseline characteristics of the patients, initial hyperlipidemia was the most important factor affecting the recurrence of symptoms (relative risk=5.810, p=0.031). The presence of a dorsal arch was also a significant factor (relative risk=0.675, p=0.047). CONCLUSION: The major factors that affect the recurrence of symptoms after endovascular treatment for femoropopliteal arterial occlusive lesions are hyperlipidemia and the presence of a dorsal arch. Therefore, the usage of lipid-lowering agents after endovascular treatment and taking the presence of a dorsal arch into consideration are important elements of managing the recurrence of symptoms.

Comparison of Two Year Follow-Up Results in High Flexion Total Knee Arthroplasty with Lospa and Scorpio NRG / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to evaluate the clinical and radiologic results after high flexion Lospa (Corentec Inc.) and Scorpio NRG (Stryker Inc.) total knee arthroplasty. MATERIALS AND METHODS: We prospectively compared 205 knees in 128 patients who underwent arthroplasty using Lospa (group A) and 164 knees in 102 patients who underwent arthroplasty using Scorpio NRG (group B) from September 2010 to March 2012 at Department of Orthopaedic Surgery, Sun General Hospital (Daejeon, Korea). Mean follow-up period was 23 months in group A and 24 months in group B. The radiologic analysis included the change of mechanical axis deviation and femoro-tibial angle, implant position (alpha, beta, gamma, delta), and patellar tilt. The clinical results were evaluated according to hospital for special surgery (HSS), knee society score (KSS), and range of motion. RESULTS: Mechanical axis deviations were change in varus from 34.8 mm to 2.6 mm (p=0.02) in group A, and change in varus from 34.3 mm to 3.1 mm (p=0.04) in group B; no statistically significant difference was observed between them (p=0.13). Femoro-tibial angles were varus 4.3degrees to valgus 6.6degrees (p=0.02) in group A, and varus 4.4degrees to valgus 6.5degrees (p=0.03) in group B; no significant difference was observed between them (p=0.25). No significant difference in implant position was observed between the two groups (p=0.25 in alpha, p=0.17 in beta, p=0.12 in gamma, p=0.17 in delta). Mean HSS improved from 48.5 to 93.6 (p=0.02) in group A, and from 41.4 to 94.4 (p=0.01) in group B. CONCLUSION: Lospa total knee arthroplasty showed excellent early radiologic, clinical results and no statistically significant difference in the results was observed between Lospa and Scorpio NRG.

Ultrasonographic Evaluation of Flexor Hallucis Longus Tenosynovitis in Sports Players / 대한스포츠의학회지

The purpose of this study was to investigate the ultrasonographic features of flexor hallucis longus (FHL) tenosynovitis in sports players. High-resoluted ultrasound was used to measure the thickness and echogenicity of the flexor hallucis longus at the posteromedial ankle, especially the fibro-osseous tunnel, for 60 sports players (120 feet). They were compared with their asymptomatic feet. There were two group; group 1 was symptomatic feet, 2 was asymptomatic. The 36 males (72 feet) and 24 females (48 feet) had an average age of 21.3 years (range, 18.23 years). Thickness, echogenicity of the tendon on each group were evaluated by the ultrasonography and the results were statistically analyzed. The mean thickness of the FHL on group 1 was 3.4+/-1.2 mm, 2.1+/-1.3 mm on group 2. There was significant difference between two groups (p=0.002). The thickness of FHL based on gender and location was not significant different (p>0.05). For group 1, increased thickness of the FHL and reduced echogenicity, peritendious fluid collection were observed in ultrasonographic findings.Increased thickness (>3 mm) and hypoechoic lesion, peritendinous fluid collection of the tendon were sonographic findings at the posteromedial ankle in the FHL tenosynovitis. The authors suggested that Ultrasonography is a valuable and alternative tool for the evaluation of FHL tenosynovitis.

Application of Percutaneous Cardiopulmonary Support for Cardiac Tamponade Following Blunt Chest Trauma: Two Case Reports

Since the advent of percutaneous cardiopulmonary support (PCPS), its application has been extended to massively injured patient. Cardiac injury following blunt chest trauma brings out high mortality and morbidity. In our cases, patients had high injury severity score by blunt trauma and presented sudden hemodynamic collapse in emergency room. We quickly detected cardiac tamponade by focused assessment with sonography for trauma and implemented PCPS. As PCPS established, their vital sign restored and then, they were transferred to the operation room (OR) securely. After all injured lesion repaired, PCPS weaned successfully in OR. They were discharged without complication on day 26 and 55, retrospectively.

Histologic Degree of Invasion and Prognosis in Follicular Thyroid Carcinoma / 대한내분비외과학회지

PURPOSE: Follicular thyroid carcinoma (FTC) is the second most common malignancy of the thyroid after papillary thyroid carcinoma, constituting about 10% of all thyroid malignancies. The objective of the current investigation was to determine whether there was a direct relationship between the histologic degree of invasion, tumor recurrence, and patient survival. METHODS: We retrospectively reviewed the records of 55 patients with a histologic diagnosis of pure follicular carcinoma of the thyroid who were treated from 1990 to 2003 at the Presbyterian Medical Center in Jeonju, Korea. Their mean follow-up period was 8.4 years (range, 1~15 years). The following criteria were used to histologically define malignant follicular neoplasms: 1) minimally invasive, tumor invasion through the entire thickness of the tumor capsule; 2) moderately invasive, tumor with angioinvasion (with or without capsular invasion); and 3) widely invasive, broad area or areas of transcapsular invasion of thyroid and extrathyroid tissue. RESULTS: Among 33 patients with capsular invasion only, 2 patients (6%) developed recurrent disease. Of the 16 patients who had angioinvasion with or without capsular invasion, 4 patients (25%) developed recurrent disease. Among 6 patients who had widely invasive FTC, 5 patients (83%) developed recurrent disease, and 2 of those 6 patients (33%) with widely invasive FTC died of the disease. Patients who had widely invasive FTC had greater recurrence rates than patients who had a capsular or angioinvasion (P<0.001). The overall death rate for patients with widely invasive FTC was 33%. CONCLUSION: This study shows that patients with widely invasive FTC had greater recurrence rates and poorer survival than patients who had capsular or angioinvasion; this difference was statistically significant. The authors conclude that patients who had widely invasive FTC need close follow-up and active treatment.

Tuberculosis of the Thyroid Gland - Report of Two Cases and Review of the Literatures / 대한내분비외과학회지

PURPOSE: Tuberculosis of the thyroid gland is very rare and some cases were reported in Korea since 1968. We experienced a case of tuberculous thyroiditis and found a old case in our medical center. This report is about the two case and the review of all cases reported about tuberculosis of the thyroid gland in Korea. METHODS: We present the case of a 55-year-old woman with thyroid tuberculosis who has been treated with antituberculous medication because of tuberculous meningitis during 6 months. We performed thyroid isthmectomy and she is now taking the antituberculous drugs. We found a case of 40- year-old woman who underwent extended thyroid lobectomy, Lt. in 1985 at our medical center. We reviewed the 18 literatures with 29 cases of tuberculosis of the thyroid gland reported in Korea and analyzed total 31 cases (reported 29 cases and our 2 cases). RESULTS: 28 patients were women and only 2 patients were over 60 years old. 26 patients had complained the neck mass. Duration of symptoms were below 6 months in 18 cases. There were associated symptoms like as weight loss, easy fatigue or generalized weakness, dysphagia, palpitation, fever, chills and/or anorexia. Only 9 patients had underlying tuberculosis - 2 meningitis, 2 pneumonia, 3 lymphadenopathy and 2 pneumonia combined with meningitis. But 3 patients were newly diagnosed as old or active pulmonary tuberculosis at the time of diagnosis of thyroid tuberculosis. Thyroid function was normal in 9 cases and abnormal in 5 cases. 3 cases were diagnosed nonoperatively and 15 patients of surgically treated 28 cases were underwent lobectomy. AFB stain was positive in only 13 cases and 2 cases were positive of culture with negative AFB stain. All of cases were diagnosed by pathology as granulomatous tuberculosis with caseous necrosis. CONCLUSION: Either surgical resection plus antituberculous medications or only medications are effective and recurrences were not reported after any initial treatments. So preoperative evaluation is very important and will guide the patient and the surgeon to the most effective management.

Nip2 Expression of Postnatal, Aged and Transient Focal Cerebral Ischemic Rat / 대한해부학회지

Nip2 mRNA expression of hippocampus was clarified in the postnatal, adult and aging rat. We observed the change of Nip2 mRNA expression in the ischemic rat hippocampus at 3, 6, 24 and 72 hours after reperfusion. And we investigated the relation between Nip2 and apoptosis after ischemic insults. The Rats were killed 2, 4, 7 days after birth and normal adult rats and aged rat were killed. Male F344 rats were subjected to transient middle cerebral artery occlusion. Reperfusion was achieved by withdrawing the filament after 90 min minutes, and rats were sacrificed 3, 6, 24, 72 hours after reperfusion. Hippocampal sections were stained for TUNEL using ApopTag kit following the protocol provided by the manufacturer, and stained with 2, 3, 5 -triphenyl tetrazolium chloride and cresyl violet We used quantitative reverse transcription and polymerase chain reaction to characterise changes in the mRNA expression of Nip2 in the rat models of transient focal ischemia and postnatal, adult and aged rat. Nip2 mRNA expression were increased in the rat of postnatal development and aging more than these of adult. After reperfusion, marked increase of Nip2 mRNA was observed after 3 and 6 hours. After that time mRNA expression of Nip2 was decreased gradually. The TUNEL staining detected DNA fragmentation in neurons of the entorhinal cortex, forcep major corpus callosum and secondary visual cortex at 24 hours. And TTC staining results showed the whitish infact changes of hippocampal CA1 region and lateral habenular nucleus. We hypothesize that the overexpression of Nip2 is concerned with sensitivity to the ischemic insult at postnatal period and aging period. And, early apoptotic events after cerebral ischemic insults relate to Nip2 mRNA overexpression.

Radial Nerve Palsy Complicating Humerus Shaft Fracture / 대한정형외과학회잡지

The authors reviewed 17 patients with radial nerve palsy complicating fracture of humerus who were treated at the Department of Orthopedlc Surgery, St. Mary's Hospital Catholic Medical College, for past 3 years from Jan. 1974 to Dec. 1976, and the following results were obtalned. 1. The ratio of male to female in 17 cases with radial nerve palsy was 4 to 1, and In patients within the first decade the ratio was same (1:1). But those in the 3rd and 4th decade showed high incidence of palsy. 2. Among 113 humerus shaft fractures, 17 cases (15.0%) complicated the radial nerve palsy; among 17 cases the middle shaft fractures were 15, lower 2, none in the upper third. 3. The radial nerve was the most vulnerable to injury at the middle third of the humerus, especially when there was comminution of fracture. 4. The incidence of radial nerve palsy in closed fracture (102 cases) was 13.7% (14 cases), and 27.2% (3cases) in open fracture (11 cases). 5. By early surgical exploration the practlcal cause of radial nerve palsy in 9 cases were found; 2 cases by bruise, 2 by interposition, 2 severance of nerve, one stretching, one impaled, and one unknown. 6. There were no signiflcant correlation between the type of nerve damage and the degree of its recovery, and between duration of paralysis since onset and its prognosis. 7. Of the 17 cases with palsy, complete recoveries were obtained 11 cases, 5 incomplete, and no recovery in one.