The Effect of Socioeconomic Status to Depression of Perimenopause Women: Pathway Analysis Using the Reserve Capacity Model

Purpose@#Based on the Reserve Capacity Model, this study investigated the effects of pre- and postmenopausal women’s socioeconomic status (SES) on depression, focusing on the mediating effects of self-esteem, happiness, and family relationship satisfaction with social network relationships. @*Methods@#This cross-sectional study involved secondary analysis of national data on 771 perimenopause women gathered from the 16th Korea Welfare Panel Study (KOWEPS) 2021. A path analysis model was constructed to evaluate the relationship between SES, social network satisfaction, self-esteem, perceived health status, and depression. Data were analyzed using ADANCO 2.3.1 and Mplus 8.4. @*Results@#Although SES had no direct effect on depression, it did affect depression through self-esteem, happiness, and satisfaction with family relationships. @*Conclusion@#The findings of this study indicate that perimenopausal women’s personal resources—psychosocial variables such as self-esteem and happiness—had a higher effect on depression than tangible reserves like SES. Therefore, interventions for enhancing self-esteem and happiness may prevent depression in perimenopausal women effectively.

Single-cell RNA sequencing identifies distinct transcriptomic signatures between PMA/ionomycin- and αCD3/αCD28-activated primary human T cells

Immunologists have activated T cells in vitro using various stimulation methods, including phorbol myristate acetate (PMA)/ionomycin and αCD3/αCD28 agonistic antibodies. PMA stimulates protein kinase C, activating nuclear factor-κB, and ionomycin increases intracellular calcium levels, resulting in activation of nuclear factor of activated T cell. In contrast, αCD3/αCD28 agonistic antibodies activate T cells through ZAP-70, which phosphorylates linker for activation of T cell and SH2-domain-containing leukocyte protein of 76 kD. However, despite the use of these two different in vitro T cell activation methods for decades, the differential effects of chemical-based and antibody-based activation of primary human T cells have not yet been comprehensively described. Using single-cell RNA sequencing (scRNA-seq) technologies to analyze gene expression unbiasedly at the single-cell level, we compared the transcriptomic profiles of the non-physiological and physiological activation methods on human peripheral blood mononuclear cell–derived T cells from four independent donors. Remarkable transcriptomic differences in the expression of cytokines and their respective receptors were identified. We also identified activated CD4 T cell subsets (CD55+) enriched specifically by PMA/ionomycin activation. We believe this activated human T cell transcriptome atlas derived from two different activation methods will enhance our understanding, highlight the optimal use of these two in vitro T cell activation assays, and be applied as a reference standard when analyzing activated specific disease-originated T cells through scRNA-seq.

Distribution of Medical Service Use for Facial Palsy Between Medicine and Traditional Korean Medicine Based on Population-Based Data of Korea

We investigated the distribution of medical service uses for Bell’s palsy and Ramsay Hunt syndrome between medicine and traditional Korean medicine using the National Health Insurance Service National Sample Cohort data of Korea from 2006 to 2015. Patients were identified with diagnostic codes and medication or treatment claim codes. For Bell’s palsy, there were 5,970 (68.8%) patients who used traditional Korean medical service only, whereas for Ramsay Hunt syndrome, there were 749 (93.6%) patients who used medical service only.The proportion of traditional Korean medical service use was higher than that of medical service use in patients with Bell’s palsy, while the opposite was found in patients with Ramsay Hunt syndrome.

Reminiscence-Narrative Therapy for Hospitalized Elderly Patients with Depression: A pilot study / 의료커뮤니케이션

Background@#Reminiscence therapy is a form of psychotherapy that ameliorates elderly depression and mental stability. It is more effective when integrated with narrative therapy. This study examined the effects of narrative therapy-based reminiscence therapy on depression, anxiety, self-esteem, and self-integration among elderly depression patients admitted in an open psychiatric ward.Method: We used a non-equivalent control group, a pre-/post-test design, and a convenience sampling method. The study was conducted in the open psychiatric ward of two hospitals from December 2016 to January 2018. The intervention program consisted of five sessions of 40 minutes each. The experimental group received the intervention for five consecutive days while the control group received standard care. We performed descriptive statistics, matched paired t-tests, and independent-sample t-tests to analyze the data. @*Results@#Fifty-six elderly patients from both hospitals completed the study (experimental group=26, control group=30). A statistically significant difference (t=2.45, p=.022) was found in pre-versus post-anxiety scores of the experimental group. @*Conclusion@#This study is meaningful, however, as it broadens the research horizon of intervention for elderly depression patients, especially those admitted to university hospitals. It serves as evidence for nursing intervention for elderly depression patients admitted to psychiatric wards.

The Korean Version of the Barkley Deficits in Executive Functioning Scale: Clinical Utility in Adult Attention-Deficit/Hyperactivity Disorder / 신경정신의학

Objectives@#To identify the clinical utility of the Korean version of the Barkley Deficits in Executive Functioning Scale (K-BDEFS) assessing executive functioning. @*Methods@#The patient group included 144 adult attention-deficit/hyperactivity disorder (ADHD) patients visiting the Adult ADHD Outpatient Clinic of the National Center for Mental Health. Adult ADHD Self-Report Scale version 1.1, Mini International Neuropsychiatric Interview, and K-BDEFS were used. The control subjects were 144 age, sex, and education-matched general adults who participated in the study of the validity of the K-BDEFS in Samsung Medical Center. @*Results@#An analysis of the mean total K-BDEFS score, executive functioning symptom count, and ADHD-executive function (EF) index score revealed a significant difference between the adult ADHD and control group (p<0.05). Five subscales of the K-BDEFS, which assess the specific domains of the executive function, revealed a significant difference between the ADHD group and control group (p<0.05). The area under curve (AUC) of the K-BDEFS total score, the EF symptom count, and the ADHD-EF index were 0.943, 0.949, and 0.908, respectively, in the analysis using the receiver operating characteristic curve. All AUC values were over 0.90. Therefore, KBDEFS is a reliable and valid screening instrument for diagnosing adult ADHD. In an assessment of the sensitivity and specificity of the cutoff scores, a cutoff of 183.5 points for the K-BDEFS total score, 26.5 points for the EF symptom count, and 23.5 points for the ADHD-EF index showed a reliable sensitivity and specificity above 80%. @*Conclusion@#To the best of the authors’ knowledge, this is the first study to examine the predictive validity and clinical utility of K-BDEFS in adult ADHD. The results suggest that the K-BDEFS could be used as a valid and reliable tool for the diagnosis and clinical intervention of adult ADHD.

Early Linguistic Developments of Simultaneous Bilateral Cochlear Implantees / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The present study aimed to compare receptive and expressive language development in children who have undergone simultaneous bilateral cochlear implantation (SCI) and those who have undergone bimodal stimulation (unilateral CI+ hearing aid). SUBJECTS AND METHOD: In a retrospective analysis of clinical data, 15 pediatric patients who have received SCI and nine patients who have received bimodal stimulation (BM group) were enrolled. CI was performed for all patients at 24 months of age. Category of Auditory Performance (CAP) scores, Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores, and developmental quotients (DQ) for expressive and receptive language were compared between the groups at 12 month of follow-up. The Percentage of Consonants Correct (PCC) of children evaluated at 4 years old was also compared. RESULTS: At 12 months of follow-up, significantly greater improvements in CAP scores (Δ4.25±0.5) were noted in the SCI group compared to the BM group (Δ3.56±0.88, p=0.041). Significantly greater improvements in IT-MAIS scores were also noted in the SCI group (Δ36.17±4.09) than in the BM group (Δ30.17±2.91, p=0.004). The DQ of receptive language was higher in the SCI group than in the BM group (87.6±15.4% vs. 75.5±12.0%, p=0.023) at 12 months of follow-up. Moreover, early SCI was associated with better receptive language skills. PCC index of children at 4 years old was higher in the SCI group than in the BM group (88.5±13.2% vs. 62±15.8%, p=0.014). Earlier SCI was associated with even greater improvements. CONCLUSION: Bilateral SCI is associated with significant improvements in language development when compared with bimodal stimulation. Earlier SCI was associated with better outcomes.

Limitation of High Pitch Sound Perception in Nontumor Patients with Auditory Brainstem Implantation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Auditory brainstem implantation (ABI) is another option for hearing rehabilitation in non-neurofibromatosis type 2 patients who cannot undergo cochlear implantation (CI). However, the average performance of ABI is worse than that of CI. We analyzed the psycho-electrical parameters of each electrode and psycho-acoustic response to different frequency sounds in nontumor patients with ABI. SUBJECTS AND METHOD: Sixteen patients with ABI from July 2008 to May 2013 were included in the study. They were followed up for 4 to 56 months. Among them, 12 were prelingual deaf with a narrow internal auditory canal or cochlear ossification. The remaining four were post-lingual deaf adults with severely ossified cochleae. We analyzed the electrical parameters [impedance, threshold level (T level), and dynamic range] of each of the 12 electrodes. We also evaluated the sound field pure-tone threshold, Ling 6 sound detection-identification test (Ling 6 test), and pitch ranking data of these patients. RESULTS: The impedance, T level, and dynamic range did not significantly differ among electrodes. However, the pure-tone threshold to sound field stimulation was elevated in the high tone area, where more variables were found than in the low frequency area. Patients could not identify /S/ and /Sh/ sounds in the Ling 6 test. The mean T level and the dynamic range of the three highest pitch-perceiving electrodes in each patient was higher and narrower, respectively, than those of the three lowest pitch-perceiving electrodes. CONCLUSION: The nontumor patients with ABI have difficulty perceiving high pitch sound. More sophisticated penetrating type electrodes and, if possible, bimodal stimulation with CI, could be considered.

Determinants Analysis of Satisfaction with Supporting System for Hearing Aids / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hearing disability has a negative impact on the psychological condition and the quality of life of patients, as well as their daily lives. This study tries to identify the relationship between personal perception of the national supporting system for hearing aids and the satisfaction of the supporting system on the part of users, suppliers and specialists. SUBJECTS AND METHOD: A total of seven questions were developed to identify factors that can affect the satisfaction of national supporting system for hearing aids. We surveyed hearing aids users, suppliers, and specialist; the final sample included 455 subjects. RESULTS: Determinants of satisfaction were adequacy of accepted durability of hearing aids, accessibility to relevant information, necessity of graded financial support by type of hearing aids, necessity of supporting repair cost and necessity of graded financial support by kind of disability rating. According to the results of multiple logistic regression analysis, subjects who answered that accepted durability of hearing aids [odd ratio (OR): 2.03, confidence interval (CI): 1.14-3.60] and accessibility to information (OR: 4.82, CI: 2.65-8.78) were proper showed tendency to be satisfied with support system for hearing aids. The subjects who answered that graded financial support by kind of hearing aids (OR: 1.98, CI: 1.10-3.59) and graded financial support by kind of disability rating (OR: 1.91 CI: 1.07-3.42) were necessary showed tendency to satisfy with support system for hearing aids. CONCLUSION: In order to enhance satisfaction in stakeholder perceptions of supporting system for hearing aids, the system needs provide users with better access to relevant information and help in the use and management of the hearing-aid device.

Auditory Outcome of Cochlear Implantation in Adolescent and Adult Patients with Enlarged Vestibular Aqueduct and Biallelic SLC26A4 Mutations / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mutations of the SLC26A4 gene cause congenital hearing loss and enlarged vestibular aqueduct (EVA). A considerable proportion of patients with SLC26A4 mutations have significant residual hearing at birth that eventually worsen and become the cause for cochlear implantation (CI) later in their adolescence or adulthood. We analyzed the auditory outcome and prognostic factors of CI in patients with EVA and biallelic SLC26A4 mutations showing progressive early-onset hearing loss, who eventually had implantation in their adolescent or adult periods. SUBJECTS AND METHOD: Sixteen patients with EVA carrying biallelic SLC26A4 mutations who received CI after 12 years of age were included for analysis. The outcome and prognostic factors of CI were analyzed. The postoperative follow-up period ranged from 3 to 48 months. RESULTS: The age at CI ranged from 12 to 44 years. The categories of auditory performance score was significantly improved after CI from 3.1 to 4.9 (p < 0.05). The mean sentence scores improved significantly in the auditory-visual and auditory-only conditions (p < 0.05). The significant prognostic factors were measurable bone conduction thresholds, preoperative residual hearing, recent history of sudden aggravation of hearing loss, and preoperative speech intelligibility rating scores. There was a tendency of lower postoperative sentence scores in the group with homozygous H723R mutation, but statistical significance was not reached. CONCLUSION: Despite the early-onset of hearing loss, significant improvement in auditory performance can be expected after CI in adolescent and adult patients with EVA and biallelic SLC26A4 mutations. Significant prognostic factors should be considered in selecting candidates and preoperative counseling for CI.

Incidence of Primary Liver Cancer in Subjects with Chronic Hepatitis B in Korean National Liver Cancer Screening Program

BACKGROUND/AIMS: To optimize efficacy of National Liver Cancer Screening Program (NLCSP) for subjects with chronic hepatitis B (CHB), it is needed to know the incidence of liver cancer and its predisposing factors in the program. METHODS: From January 2010 to December 2014, all the hepatitis B surface antigen (HBsAg) positive participants who received at least two or more abdominal ultrasonography under NLCSP were retrospectively enrolled in a single tertiary hospital. Annual incidence of primary liver cancer was calculated and related clinical factors were investigated. RESULTS: During 5 years, 541 subjects were enrolled. Mean age was 53 years old and 292 subjects (54%) were receiving antiviral agents. Liver cirrhosis (LC) was diagnosed in 212 (39.2%). Mean follow-up time was 2.36 years and 15 hepatocellular carcinoma and 1 intrahepatic cholangiocarcinoma were diagnosed. Annual incidence of primary liver cancer was 9.8 per 1,000 patient year. Cumulative incidence at 1, 3, and 5 year was 0.6%, 2.6%, and 6.4%, respectively. In multivariate analyses, LC (hazard ratio [HR] 8.74, 95% confidence interval [CI] 1.97–38.71, P=0.024), age (HR 1.08, 95% CI 1.01–1.15, P=0.024) were significantly associated with cancer development. CONCLUSIONS: Despite of high rate of oral antiviral therapy, incidence of primary liver cancer is not low in CHB patients in Korea. Old age and presence of LC are independently associated with higher risk of cancer development during surveillance. This study could be used as baseline data for quality control of NLCSP.

Hypocomplementemic Urticarial Vasculitis Syndrome with Membranous Nephropathy: Case Report

Urticarial vasculitis is a rare disorder that principally manifests with recurrent urticarial, sometimes hemorrhagic, skin lesions and/or angioedema. Its clinical presentation is not always limited to cutaneous lesions and it can potentially affect other organs, such as the joints, lungs, kidneys, and eyes. Systemic involvement can either be present at the onset of disease or develop over time. In cases with systemic manifestations, urticarial vasculitis is more likely to be associated with a low complement level. We present the case of a teenage boy with hypocomplementemic urticarial vasculitis syndrome (HUVS) that occurred shortly following swine-origin influenza A virus infection in 2009. Afterwards, HUVS was systemically complicated with myositis and membranous nephropathy that developed several months and about 2 years after its onset, respectively. A combination of glucocorticoid and immunosuppressive agents has been used to effectively control disease activity.

Is Pediatric Otitis Media Correlated with an Increased Risk of Bronchial Asthma?: An II-Year Nationwide Population-Based Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pediatric otitis media is closely related to upper respiratory illness and is one of the most common causes of hospital visiting and antibiotic prescription. Although there are many studies of asthma with other upper respiratory tract infections, few studies have investigated the relationship between asthma and otitis media. This study estimated whether pediatric otitis media is associated with the risk of asthma using the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC 2002-2013) data. SUBJECTS AND METHOD: In using the NHIS-NSC 2002-2013 data, children diagnosed as otitis media or bronchial asthma in 2002 were excluded from children from 1 to 8 years old in 2003. The patients who were diagnosed and treated as otitis media (n=8506) and the comparison group (n=65886) were enrolled in 2003. During a 10-year follow-up period until December 2013, the incidence of asthma between two groups was analyzed and the result was adjusted for the impact of comorbidities such as atopic dermatitis, allergic rhinitis with multivariate linear regression analyses. RESULTS: In 2003, 20.88% of first-year-old children were treated with otitis media. The prevalence of otitis media was maintained at 15% until age 4 and decreased rapidly after 5 years of age. Asthma incidence was reported higher in patients with otitis media compared to the comparison group, with an adjusted odds ratio of 1.196 [95% confidence interval (CI) 1.127-1.269] followed by patients with atopic dermatitis [hazard ratio (HR) 1.261, 95% CI 1.196-1.33], allergic rhinitis (HR 1.473, 95% CI 1.409-1.54). CONCLUSION: Pediatric otitis media appeared to be associated with an increased risk of developing bronchial asthma after adjusting for other risk factors.

Vestibulotomy in Congenital Stapes Fixation with Anomalous Facial Nerve / 대한이비인후과학회지

Conductive hearing loss is a condition that can be corrected surgically in most cases. Stapedotomy is usually performed for patients with congenital ossicular anomaly or fixation. However, otologic surgeons have often encountered difficulty due to the complexity of stapes surgery. Moreover, congenital stapes fixation with anomalous facial nerve and oval window absence is an uncommon and dangerous condition. In such cases, vestibulotomy can be a surgical option to prevent facial nerve damage and improve hearing. The etiology can be explained by the embryological development of the middle ear structures. To prevent facial nerve damage and maximize the efficacy of surgery, the surgeon should have knowledge about this disease and take a computed tomography for double check before stapes surgery. We describe a case of congenital stapes fixation with aberrant facial nerve courses, a 15-year-old female who was treated with vestibulotomy and piston wire insertion.

Idiopathic Sudden Sensorineural Hearing Loss Is Correlated with an Increased Risk of Stroke: An 11-Year Nationwide Population-Based Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden sensorineural hearing loss (S-SNHL) occurs abruptly, developing rapidly within 3 days. The criteria for the diagnosis of S-SNHL are idiopathic hearing loss of at least 30 dB over at least three serial test frequencies. This study estimated whether S-SNHL increases the risk of stroke using Korean National Health Insurance Service National Sample Cohort (NHIS-NSC 2002-2013) data. SUBJECTS AND METHOD: Among NHIS-NSC 2002-2013, we excluded the patients diagnosed as S-SNHL or stroke in 2002. The patients who were diagnosed and treated as S-SNHL (n=2510) and the comparison group (n=12550) extracted using propensity score matching were enrolled. During an 11-year follow-up period until December 2013, the incidence of stroke among two groups was analyzed and the result was adjusted for the impact of comorbidities such as hypertension, diabetes, and chronic kidney disease with Cox proportional hazard regression. RESULTS: According to our data, 10.8% of S-SNHL patients (among 2510) and 7.8% of the comparison group (among 12550) had strokes. Stroke incidence was reported higher in patients with history of S-SNHL compared to the comparison group [hazard (HR), 1.15; 95% confidence interval (CI), 1.01-1.32] followed by patients with hypertension (HR, 2.51; 95% CI, 2.22-2.84), diabetes mellitus (HR, 1.62; 95% CI, 1.43-1.85). In terms of the type of strokes, S-SNHL increased the risk of ischemic stroke (HR, 1.18; 95% CI, 1.02-1.37). CONCLUSION: S-SNHL appeared to be associated with an increased risk of developing stroke after adjusting for other risk factors.

New monoclonal antibody-based test for Helicobacter pylori urease in gastric tissue

BACKGROUND/AIMS: To evaluate a new monoclonal antibody for Helicobacter pylori urease in gastric tissue. METHODS: A total of 107 volunteers were enrolled. All subjects underwent a 13C-urea breath test and esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia. Six biopsy specimens in the gastric antrum and body were obtained for a rapid urease test and histology. The new monoclonal antibody-based H. pylori urease test (HPU) was performed to rapidly and qualitatively detect urease in two biopsy specimens. RESULTS: H. pylori infection was diagnosed in 73 subjects. The sensitivity and specificity of the HPU was 89% and 74%, respectively. The subjects were divided into two groups: one with true-positive and true-negative HPU results (n = 90) and the other with false-positive and false-negative HPU results (n = 17). Across all subjects, ammonia levels were 900.5 +/- 646.7 and 604.3 +/- 594.3 mumol/L (p > 0.05), and pH was 3.37 +/- 1.64 and 2.82 +/- 1.51 (p > 0.05). Sensitivity was higher in the presence of atrophic gastritis or intestinal metaplasia. CONCLUSIONS: HPU detected H. pylori in approximately 10 min. Gastric aspirate ammonia and pH levels did not affect the test results. Sensitivity was good in the presence of atrophic gastritis or intestinal metaplasia.

Quercetin Directly Interacts with Vitamin D Receptor (VDR): Structural Implication of VDR Activation by Quercetin

The vitamin D receptor (VDR) is a member of the nuclear receptor (NR) superfamily. The VDR binds to active vitamin D3 metabolites, which stimulates downstream transduction signaling involved in various physiological activities such as calcium homeostasis, bone mineralization, and cell differentiation. Quercetin is a widely distributed flavonoid in nature that is known to enhance transactivation of VDR target genes. However, the detailed molecular mechanism underlying VDR activation by quercetin is not well understood. We first demonstrated the interaction between quercetin and the VDR at the molecular level by using fluorescence quenching and saturation transfer difference (STD) NMR experiments. The dissociation constant (K(d)) of quercetin and the VDR was 21.15 ± 4.31 µM, and the mapping of quercetin subsites for VDR binding was performed using STD-NMR. The binding mode of quercetin was investigated by a docking study combined with molecular dynamics (MD) simulation. Quercetin might serve as a scaffold for the development of VDR modulators with selective biological activities.

Study about Economic Adequacy of Tonsillectomy and Adenoidectomy Based on Medical Prime Costs / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Korean National Health Insurance is based on 'fee for service' system, but recently 7 groups of diseases were forcibly applied to diagnosis related groups (DRG) system. In these 7 group of diseases, tonsillectomy and adenoidectomy were included in the otorhinolaryngology field. The objective of this research is to estimate the invested medical costs, profit and loss, and improvement points for the disease groups according to DRG and 'fee for service' system. SUBJECTS AND METHOD: We investigated 1,377 subjects who underwent tonsillectomy and adenoidectomy based on DRG between January 2011 to December 2013 at our hospital. The profit and loss of medical costs were calculated according to medical record data, medical service fee, and activity based costing (ABC). RESULTS: The total of 1,377 subject comprised of 905 patients younger than 17 years-old and 472 patients older than 18 years-old. A main moderate complication that was not one of the DRG diseases, postoperative bleeding, was only found in 19 patients (1.38%). Profit related to tonsillectomy and adenoidectomy studied for a 3 year-period was higher in the DRG system than in the 'fee for service' system; however, profit was reported as 62.9-67.5% of the actual prime costs. CONCLUSION: DRG system for tonsillectomy and adenoidectomy seems to have higher compensation rate than the 'fee for service' system does. However, the system is still insufficient to compare profit with the input medical cost. Furthermore, the present system of disease grouping needs to be improved to reflect actual medical prime costs.

A Case of Diffuse Large B-cell Lymphoma with Liver Involvement in a 67-Year-Old Woman Given Methotrexate for Rheumatoid Arthritis / 대한내과학회지

Prolonged inflammation or immunosuppression may cause lymphoproliferative disorders (LPD). Rheumatoid arthritis (RA) itself causes LPD. The immunosuppressive drug methotrexate (MTX) is used widely to treat RA, and is also related to the development of lymphoma. Although the detailed pathogenesis and association are still controversial, care is needed when managing patients with RA treated with MTX. Many reports indicate that discontinuing MTX can induce the regression of LPD. Here, we describe a case of diffuse large B-cell lymphoma that presented with liver involvement in a 67-year-old woman who had used MTX for RA for 15 years.

The Prevalence and Risk Factors of Tinnitus in Korean Adolescents / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tinnitus is the perception of sound in the absence of any outside acoustic stimulus with high prevalence. Multiple risk factors for tinnitus have been identified. So far, most of studies have concentrated on prevalence and associated chronic disease of tinnitus in adults. In the present study, we focused on tinnitus in adolescents which has not been adequately evaluated. The main goal of this study was to assess the prevalence and associated risk factors of tinnitus in adolescents. SUBJECTS AND METHOD: This study was a retrospectively designed analysis of data from the 5th Korea National Health and Nutrition Examination Survey conducted in 2011-2012. We used tinnitus related interview data, the results of physical and audiological evaluation by ENT specialists, the results of daily intake of vitamin using a 24-hour dietary recall method, and blood samples in 1370 subjects. RESULTS: The prevalence of tinnitus was 22.2% in the age range of 12 and 19 years old. Logistic regression is a statistical method used to assess the association between tinnitus and independent variables. The following factors were independently and positively associated with tinnitus; sex (adjusted OR=1.531, CI=1.097-2.137), excessive earphone use (adjusted OR=1.422, CI=1.026-1.970), Non-occupational noise (adjusted OR=4.096, CI=1.702-9.859), explosive noise (adjusted OR=4.100, CI=1.703-9.872), niacin intake (adjusted OR=0.966, CI=0.940-0.993), vitamin (vit.). D serum concentration (adjusted OR=0.959, CI=0.925-0.994). CONCLUSION: This study showed an association between tinnitus prevalence in adolescents and gender, noise exposure, and vit. D supplement. Tinnitic patients are recommended to reduce excessive noise and use hearing protection devices such as earplugs or earmuffs; they are also recommended to obtain a supply vit. D from adequate sun exposure and outside activities.

A Case of Herpes Zoster Oticus Involving Multiple Cranial Nerves without Facial Palsy / 대한이비인후과학회지

Varicella zoster virus (VZV) infection of the head and neck region may present with various symptoms. We present a case of VZV infection of the external ear (cranial nerve V), pharynx and larynx with neuropathy of three ipsilateral lower cranial nerves (IX, X, XII). The patient's paresthesia was reduced after antiviral therapy and oral steroids. By the end of one month follow-up, the patient showed normal movement of vocal cord, soft palate and tongue.