The Effect of Ginkgo Biloba on the Survival of Spiral Ganglion Neurons in Rats / 대한이비인후과학회지

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.

The Relationship between the Change of Otoacoustic Emission and Temporary Threshold Shift after Broad Band Noise Stimulation / 대한이비인후과학회지

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.

Change of Stapedial Reflex Threshold according to the Depth of Intravenous Propofol Anesthesia / 대한이비인후과학회지

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.

Relationship between Degree of Enophthalmos and Orbital Volume Measured with Computed Tomography in Isolated Blowout Fractures of the Orbit / 대한이비인후과학회지

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.

Clinical Significance in Expression of p53, Bcl-2, PCNA and VEGF in Head and Neck Squamous Cell Carcinoma: Relationships with Cisplatin Chemosensitivity and Prognosis / 대한이비인후과학회지

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.

Development of Web-Based Digital Air-Conduction Pure Tone Audiometer with Automated Masking / 대한이비인후과학회지

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.

The Effects of Test Positions and Acoustic Stimulations on the Vestibular Evoked Myogenic Potentials

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.

Change of Otoacoustic Emissions in Early Stage of Meniere's 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.

Change of Otoacoustic Emissions in Early Stage of Meniere's 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.

Frequencies of Tinnitus and Noise of the Factory in Noise-induced Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was designed to evaluate relation between frequencies of noise and tinnitus in noise-induced hearing loss and to elucidate mechanism of tinnitus in noise-induced hearing loss. MATERIALS AND METHODS: Four factories were selected, of which noise frequencies were different except one factory. Preliminary screening hearing test with a pure tone audiometer on 1000 and 4000 Hz was done. And if the hearing threshold was over 40 dB, history taking, otological examination, tympanometry, pure tone audiometry on 500, 1000, 2000, 4000, 6000 Hz were done. Noise was measured in 125, 250, 500, 1000, 2000, 4000, 8000 Hz. Tinnitus was measured using 1000, 2000, 4000 Hz pure tone. RESULTS: 1) Hearing loss was most severe in the 4000, 6000 Hz range. 2) In A factory, noise was most intense on 4000 Hz, in B factory on 2000 Hz, and in C and D factory on 1000 Hz. 3) Forty-three workers (42.2%) of total 102 subjects complained tinnitus. And frequency of tinnitus was 4000 Hz in 71 ears (89.9%) among 79 ears with tinnius. CONCLUSION: Regardless of the frequency of noise, most workers complain of 4 kHz tinnitus. And it was in accord with frequency of most severe hearing loss in the noise-induced hearing loss.

A Case of Ossifying Fibroma of the Temporal Bones / 대한이비인후과학회지

We report, with a review of literature, an unusual case of ossifying fibroma of temporal bone. A 34-year-old female with history of left craniectomy for hemifacial spasm visited our department in 1998 because of an incidentally found temporal bone mass. Magnetic resonance imaging showed a well-circumscribed, lobulated 3x3x3 cm sized tumor mass which was localized in the temporal bone but did not invade the middle and inner ear with high signal intensity at T2 weighted image. The patient did not have the spasm until 2000, when she manifested intermittent right otalgia. A computed tomography scan showed the 3x3x3 cm sized right temporal bone tumor with bony erosion including tegmen mastoid and partial bony destruction. After retroauricular incision, tumor and granulation tissue were removed through simple mastoidectomy. The permanent pathologic report confirmed the diagnosis of ossifying fibroma. The patient returned in August of 2004 with recurrent right otalgia that had been there for 3 months. A computed tomography scan showed lobulated, multiseptated, osteolytic, low density tumor which located in the upper portion of mastoid pyramidal base. She underwent a simple mastoidectomy with removal of the recurred ossifying fibroma with destruction in tegmen mastoid. Ossifying fibroma are rare lesions of the temporal bone. Because tumors progress and can become clinically massive, early complete resection is advised whenever feasible to prevent clinically evident recurrences and potentially life-threatening complication.

Detection of Ammino Acids Using Microdialysis Technique and Changes of Amino Acid Concentrations in Experimentally Induced Nasal Allergy Model / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The basic principle of microdialysis is to mimic the function of a capillary blood vessel by perfusing physiologic liquid implanted into the target tissue. Amino acids are supposed to have functions for controlling the homeostasis of normal nasal mucosa and a role in the pathogenesis of allergic rhinitis. However, no studies have been conducted about the existence of amino acids in the nasal cavity. This study measures the concentration of 19 amino acids found in the nasal cavity of normal control and experimentally allergy-induced animal model in order to evaluate the difference in the concentration of amino acids between normal and allergic nasal mucosa. MATERIALS AND METHOD: An experimentally induced nasal allergy model was developed by intraperitoneal and intranasal sensitization with ovalbumin in Dunkin-Hartely guinea pigs according to a programmed protocol. A microdialysis probe was designed to be suitable to nasal mucosa using a Cuprophan hollow fiber (200 micrometer inner diameter, 300 micrometer outer diameter, 45 kDa molecular weight cut-off, Fitral, AN 69-HF). After verification of the probe, microdialysis was performed in the inferior turbinate submucosa of normal control (N=8) and experimental (N=8) groups. The concentration of 19 amino acids was analyzed using high performance liquid chromatography. Statistical analysis was performed using a student t-test. RESULTS: All 19 amino acids were validated at various concentrations in the nasal cavity. Glutamate (p=0.036) and GABA (p<0.001) concentrations were significantly higher in the experimental group than in the control group. CONCLUSION: The 19 amino acids measured existed in the nasal cavity at various concentrations, and the concentrations of glutamate and GABA were significantly higher in the allergy group than in the control group. The microdialysis technique is a powerful tool not only to measure endogenous substances for target organ chemistry but also to pharmacokinetically evaluate exogenous drug delivery processes in the nasal cavity.

Establishment of Cisplatin Resistant Head and Neck Cancer Cell Lines and Cross-resistance of Docetaxel / 대한이비인후과학회지

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.

Relationship between Subjective Expression and Pitch in Tinnitus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The majority of tinnitus is classified not as objective, but as subjective tinnitus. The nature of tinnitus is different according to countries, cities, personal expression, but the objective assessment guideline for the diagnosis of subjective expression in tinnitus is not present in Korea. The aim of this study has been to compare subjective expressions with pitch in tinnitus and to find out whether we can predict tinnitus pitch by patient subjective expression. SUBJECTS AND METHOD: We reviewed the records of 633 patients (690 ears) with continuous tinnitus who performed questionnaires of tinnitus and audiologic study. In addition to standard audiometric tests, patients received tests for tinnitus pitch using pure tone stimuli and/ or narrow band noise. RESULTS: Among 50 onomatopoeia of tinnitus, [wi: ng] shows highest incidence (25.4%), followed by [s'oi: ](13.8%), [u: ng] (11.7%), [p'i: ](7.8%), and [tchi: ](5.4%). High pitches, especially 4 kHz (28.6%), 8 kHz (24.9%), were more frequently noted in tinnitus. With respect to the relationship between tinnitus pitch and onomatopoeia, [u: ng] shows highest incidence in low pitches, below 500 Hz, [wi: ng] in 1 kHz, and [s'oi: ] in 4 kHz, 8 kHz. In tinnitus pitch according to onomatopoeia, [wi: ng] had 4 kHz, 8 kHz, 1 kHz, [s'oi: ] had 4 kHz, 1 kHz, 8 kHz, [u: ng] had 125 Hz, 250 Hz, 500 Hz, [p'i: ] had 8 kHz, 4 kHz, 1 kHz, and [tchi: ] had 4 kHz, 8 kHz, more frequently in sequence. Dividing pitches into low, middle and high levels, [u: ng] had low pitches, [s'oi: ] had middle and high pitches, [p'i: ] and [tchi: ] had high pitches, but [wi: ng] was distributed evenly through low to high pitches. CONCLUSION: Our results suggest that there was apparent relationship between subjective expression and pitch in tinnitus.

Usefullness of Raman Spectroscopy in Differentiation between Cancer and Adjacent Normal Tissue of the Larynx / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Raman spectroscopy is a vibrational spectroscopic technique capable of providing details on the chemical composition, molecular structure and molecular interactions in cells and tissues. Its application of distinguishing normal and cancer tissue has been studied in a variety of sites, such as the cervix, lung, larynx and skin. The purpose was to explore spectral changes between normal and cancer tissue in the larynx using Raman spectroscopy to assess the feasibility of using Raman spectroscopy for the early diagnosis of laryngeal cancer. MATERIALS AND METHOD: Laryngeal tissue specimens (13 adjacent normal and 13 cancer tissues) were obtained from patients who underwent total laryngetomy or supracricoid laryngectomy with squamous cell carcinoma of the larynx. The specimens were stored -70 degrees C until use. These specimens were defrosted at room temperature. The Raman spectra from laryngeal tissue specimens could be obtained at 300 mW and 250 scan during 15 minutes of the signal acquisition time using FT-Raman spectroscopy (Bruker Co., Karsruhe, Germany). RESULTS: Raman spectra were different significantly between cancer and adjacent normal tissues of the larynx at 1446 cm-1, 1240 cm-1, 1335 cm-1, and 1655 cm-1 (p=0.007, 0.2, 0.2, 0.3, respectively). The difference of 1446 cm-1 means the change of CH2 bending mode in protein and lipid of malignant tissue. The change of 1335 cm-1 means a decrease in CH3CH2 to a wagging mode of collagen and polynucleotide chain of malignant tissue. The difference of 1240 and 1655 means a decrease in the alpha-helix conformation of collagen. CONCLUSION: This study demonstrates the differences of Raman units between laryngeal cancer and adjacent normal tissue using Raman spectroscopy. In future, Raman spectroscopy may become a useful tool of guided biopsy for accurate pathologic diagnosis and assessment of the adequacy of resection margins.

Microbiologic Study of the Ear Canal in Koreans / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was designed to isolate bacteria and fungi from healthy ear canal in Koreans and compare with known pathogens. SUBJECTS AND METHOD: Specimens were collected from the external ear swab and cerumen of 45 healthy volunteers from February 2003 to May 2003. RESULTS: Forty-five subjects were cultured. In 8 subjects, we failed to obtain enough cerumen. Three canal and 11 cerumen showed no growth. Forty-two canal specimens yielded 72 microorganisms, of which 84.7% were gram positive bacteria. Twenty-six cerumen specimens yielded 43 microorganisms and 76.7% of them were gram positive. Staphylococci was 76.4% of canal bacteria and 74.4% of cerumen bacteria. In both canal and cerumen, the most commonly isolated microorganism was Staphylococcus capitis. Coryneform bacteria were 6.9% of bacteria in canal and were not isolated from cerumen. Two Aspergillus species and one Penicillium species were isolated from canal and cerumen. CONCLUSION: Coagulase-negative staphylococcus (CNS) were found to be the predominant microorganism and, in particular, Staphylococcus capitis was the most commonly isolated microorganism from the normal external auditory canal in Koreans.

Normative Measurements of the Inner Ear Structures on Temporal Bone CT Images Using PACS / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The reports of normative measurements for inner ear structure using computer-based programs are rare. The purpose of this study was to measure the normative data of the Korean inner ear structures and establish the basic data for diagnosis of congenital inner ear anomaly. SUBJECTS AND METHOD: Temporal bone CT of 38 patients (16 men and 22 women) without apparent disease of middle and inner ear, fractures or major disorder such as seizure or tumor were retrospectively reviewed. Fifteen dimensions on axial views and 9 dimensions on coronal views were measured in PACS using pi-view program. The slice thickness of CT was 0.6 mm. RESULTS: From the axial view, the canal diameter of SSCC was 1.09+/-0.15 mm, the bony island width was 5.70+/-0.50 mm, the bony island width of LSCC was 3.99+/-0.58 mm, the cochlear upper turn width & height were each 5.63+/-1.07 and 3.03+/-0.65 mm. The vestibular aqueduct were observed 95.3%. From the coronal view, the cochlear height was 5.14+/-0.36 mm. The length of IAC was significantly longer in male than female (p10 dB). CONCLUSION: We established the Korean normative measurements of the inner ear structures, which can be used for further diagnosis of the inner ear anomaly.

The Correlations of E-Cadherin Catenin Complex(alpha, beta, gamma, p120cat) Expressions and Clinicopathological Findings in Tongue Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: E-cadherin and catenins (alpha, beta, gamma, p120cat) are important epithelial adhesion molecules in normal epithelial cells. Loss of E-cadherin-catenin adhesion is an important step in the progression of epithelial cancers such as tongue cancer. E-cadherin and catenins expression in carcinoma of human tongue was evaluated in relation to their clinicopathological features and prognostic values. SUBJECTS AND METHOD: Thirty-nine specimens of tongue squamous cell carcinoma were examined in this study. These patients were all treated by primary surgery without prior radiotherapy or chemotherapy. The specimens of formalin-fixed and paraffin-embedded tumor tissues were investigated by immunohistochemical analysis using E-cadherin and catenin (alpha, beta, gamma, p120cat) monoclonal antibodies. RESULTS: The expressions of E-cadherin, alpha-catenin, beta-catenin, gamma-catenin and p120cat in cell membranes were reduced or absent in 71.8%, 74.4%, 76.9%, 59.0% and 82.1% of the tumors examined, respectively. The reduced expressions of alpha-catenin and gamma-catenin in the cell membranes was cor-related with tumore differentiation (p=0.018, p=0.004, respectively). There were significant correlations between E-cadherin and expressions of the four cantenins in the cell membranes of tongue cancer. There were no correlations between beta-catenin and p120cat expression in the cytoplasm, cell nucleus and clinicopathological features. There was significant correlation between E-cadherin expression and Kaplan-Meier survival curves. CONCLUSION: These results suggest that E-cadherin and catenins (alpha, beta, gamma, p120cat) can be used as prognostic markers of human tongue squamous cell carninoma. The result of beta-catenin and p120cat absence in the nucleus suggests that Wnt/Wingless signaling or Kaiso transcription did not occur in the human tongue squamous cell carcinoma.

The Change of Telomerase Activity by Cisplatin and 5-FU in Head and Neck Cancer Cell Lines / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Telomerase activity appears to be associated with cell immortalisation and malignant progres-sion. Telomerase activity has been found in the majority of human tumours, but not in most somatic cells or tissues. We studied the change in the telomerase activity by cisplatin and 5-fluorouracil (5-FU) in head and neck cancer cell lines. SUBJECTS AND METHODS: Three different human head and neck cancer cell lines (PNUH-12, SNU-899, HEp-2) were studied. Cell cytotoxi-city and change of telomerase activity by 5-FU and cisplatin treatment were assessed by MTT and TRAP assays. RESULTS: The telomerase activity was detected in the head and neck cancer cell lines. After the cisplatin treatment, the telomerase activity was decreased in a concentration-dependent manner. However, after 5-FU treatment, the telomerase activity showed a slight decrease or no change at the concentration similar to that of cisplatin in the inhibition of tumor growth. CONCLUSION: Our results can explain one of the reasons why cisplatin is more effective than 5-FU in the chemotherapy of head and neck cancer.

Sudden Deafness in the Elderly / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden deafness in the elderly is rare and its prognosis is poorer than in adults. The unaffected ear also may have hearing impairment of variable severity and physiological hearing threshold shift termed presbycusis in the elderly. The old person often had various systemic complications including diabetes and hypertension. This study was designed to evaluate clinical manifestations and prognosis of sudden deafness in the elderly and to compare with sudden deafness in adults and children. SUBJECTS AND METHOD: We reviewed the medical and audiological records of 96 patients (102 ears) who are more than 60 years of age, and admitted to the Department of Otolaryngology, Pusan National University Hospital from January 1990 to December 2001. RESULTS: The total recovery rate of sudden deafness was lower in the elderly than in adults and children. Hearing recovery was significantly poorer in the patients with diabetes and hypertension. Hearing recovery was significantly poor in the patients with profound degree of hearing loss. The patients who had been treated within 7 days after onset of hearing loss showed better recovery rate than those treated 7 days later. CONCLUSION: We consider the effect of treatment of sudden deafness in the elderly to be best judged in various degrees of hearing impairment in the unaffected ear. The poor prognosis observed in patients with the concurrent disease is likely to have been brought about by preexisting microvascular diseases of the hearing organ, which is highly affected by aging. Good hearing recovery in the elderly is considered to be associated with time of initial treatment and expected in patients without concurrent diseases.