Congenital Intratympanic Membrane Cholesteatoma: Report of Three Cases and Review of the Literature / 대한이비인후과학회지

Congenital intratympanic membrane cholesteatomas (ITMCs) are very rare. We present 3 cases of congenital ITMCs. In the first case, there was a small keratin pearl in the center of the tympanic membrane. In the other cases, cholesteatomas were found in the periphery. In all cases, cholesteatomas were confined to the space between the outer epithelial layer and the middle fibrous layer. The pathogenesis of this rare disease and the natural history are not well known. In some reported cases, it grows and invades into the middle ear. However, in the present study, the lateral growing of the ITMC was observed in one of the three cases. Furthermore, it naturally grew outward and finally moved to the external auditory canal. Careful periodic observation should be considered for alternative treatments. We present three different cases of ITMC with a review of the literature.

The Association between the Therapeutic Agent and the Compliance of the Patients with Inflammatory Bowel Diseases / 대한소화기학회지

BACKGROUND/AIMS: Adherence of the patients with inflammatory bowel diseases is important to maintain the remission. However, the patients do not always keep their appointments for treatment. The aim of this study was to investigate the clinical factors associated with adherence of patients in terms of appointment keeping. METHODS: A total of 73 subjects were retrospectively investigated from September 2005 to January 2012 at Dongguk University Ilsan Hospital (Goyang, Korea). We reviewed medical records including the age, sex, residence, medications, the disease activity, and the rate of keeping the date. A punctual visit was defined as outpatient visit on the scheduled date +/-7 days. Punctual patients for the visit were defined as their punctual visit rates exceed 90%. RESULTS: Male to female ratio was 2.4:1. Mean age was 41.5+/-15.4 years (range, 20 to 78 years). Ulcerative colitis was 53 cases (72.6%) and Crohn's disease was 20 cases (27.4%). Mean duration of disease was 42.0+/-41.6 months (range, 4 to 226 months). Mean puntual visit rate was 86.7+/-16.0% (range, 27 to 100). Thirty-eight patients (52.1%) were punctual patients for the visit. Azathioprine/6-mercaptopurine treatment was associated with punctual patients for the visit (odd ratio, 3.19; 95% confidence interval, 1.12 to 9.09; p=0.03). However, other clinical factors did not influence the punctual visit rates. CONCLUSIONS: Our study demonstrated that the use of azathioprine/6-mercaptopurine was associated with keeping the appointment for meeting the doctor. Further prospective study would be necessary.

A Case of Ectopic Tooth with Superimposed Fungal Infection in Nasal Cavity of Cleft Lip and Palate Patient / 대한이비인후과학회지

Ectopic teeth (ET) occur in a wide variety of sites such as palate, mandibular condyle, coronoid process, orbit, maxillary antrum and nasal cavity. To date, the precise etiology of ET is still unknown. Although ET can be present in patients without any associated syndrome or development anomaly, it can be frequently associated with cleft lip, palate or other syndromes such as Gardner's syndrome, cleidocranial dysplasia, and etc. The Candida species are yeast fungi, which are pathogenic saprophytes, but the infection of the nose and sinuses is rare. We report a case of cleft lip and palate patient presenting with a history of foul odor, who was found to have an ectopic tooth in the nasal cavity with superimposed candidal infection.

A Case of Septochoanal Polyp

Septochoanal polyp is a rare entity in the nasal septum. This type of polyp can extend into the choana to cause nasal obstruction and snoring, similar to the symptoms of an antrochoanal polyp. Septochoanal polyps may therefore be confused with antrochoanal polyps because of their similar appearances. The authors report a case of a seven-year-old boy who was diagnosed with a septochoanal polyp. The patient was successfully treated via an endoscopic surgical approach.

Expression and Distribution of Tumor Necrosis Factor-Alpha in Mice Cochlea Exposed to Noise / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recent studies have shown that inflammatory responses occur in the inner ear under various damaging conditions including noise-overstimulation.Identification of time-dependent expression patterns of pro-inflammatory cytokines during the response initiation should lead to rational therapeutic strategies that block the response and reduce the damaging sequelae. MATERIALS AND METHOD: We evaluated the time-dependent expression pattern of pro-inflammatory cytokines in noise-exposed mouse cochlea (white noise, 120 dB SPL, 3 hours) using immunohistochemistry and reverse transcriptase-polymerase chain reaction(RT-PCR). RESULTS: The most potent pro-inflammatory cytokine, the tumor necrosis factor-alpha (TNF-alpha), was up-regulated after noise exposure. Immunohistochemical analyses showed that the TNF-alpha expression was distinctively induced within the spiral ganglion and stria vascularis. RT-PCR showed that TNF-alpha was induced shortly after noise exposure and persisted upto seven days following noise exposure. CONCLUSION: Taken together, acoustic trauma induces cochlear inflammation and the data suggest that TNF-alpha may have some role in cochlea damage that occur following noise exposure.

A Case of Multiple Fungal Balls Involving the Isolated Three Sinuses

The fungal ball usually occurs in a single sinus, most frequently in the maxillary sinus, and multiple sinus localization has rarely been reported? Recently, the authors experienced a rare case of multiple fungal balls involving three sinuses that were not contiguous, the bilateral maxillary sinuses and right sphenoid sinus. The patient had a history of endodontic treatment. We report this rare case with a literature review.

Characteristics of Type 2 Diabetes in Terms of Insulin Resistance in Korea

The aim of this study was to assess the implications of insulin resistance on the clinical and biochemical profiles of Korean type 2 diabetic patients. 122 patients with type 2 diabetes underwent a short insulin tolerance test to assess insulin resistance. Subjects were classified in tertiles according to ISI (insulin sensitivity index), and the tertile I (the insulin- resistant group) and tertile III (the insulin-sensitive group) clinical and biochemical parameters were compared. Age, waist circumference (WC), systolic blood pressure (SBP), HbA1c, body fat content, and fasting plasma glucose were significantly higher in tertile I than tertile III (all p < 0.05). The frequency of hypertension and family history of cerebrovascular disease (CVD) were greater in tertile I than III (p < 0.05). To evaluate the factors affecting ISI, multiple regression was performed, and age, WC, SBP, HbA1c, and body fat content were found to be independently related to insulin resistance (p < 0.05). Old age, hypertension, central obesity, and poor glycemic control were identified as clinical parameters of insulin resistance in Korean type 2 diabetic patients.