Comparison of the Effectiveness of Monitoring Cisplatin-Induced Ototoxicity with Extended High-Frequency Pure-Tone Audiometry or Distortion-Product Otoacoustic Emission

BACKGROUND AND OBJECTIVES: To compare the effectiveness of monitoring cisplatin-induced ototoxicity in adult patients using extended high-frequency pure-tone audiometry (EHF-PTA) or distortion-product otoacoustic emission (DP-OAE) and to evaluate the concurrence of ototoxicity and nephrotoxicity in cisplatin-treated patients. SUBJECTS AND METHODS: EHF-PTA was measured at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, 8, 9, 11.2, 12.5, 14, 16, 18, and 20 kHz and DP-OAE at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz in cisplatin-treated patients (n=10). Baseline evaluations were made immediately before chemotherapy and additional tests were performed before each of six cycles of cisplatin treatment. Laboratory tests to monitor nephrotoxicity were included before every cycle of chemotherapy. RESULTS: Four of 10 patients showed threshold changes on EHF-PTA. Five of 10 patients showed reductions in DP-OAE, but one was a false-positive result. The results of EHF-PTA and DP-OAE were consistent in two patients. Only one patient displayed nephrotoxicity on laboratory tests after the third cycle. CONCLUSIONS: In our study, the incidence rate of cisplatin-induced ototoxicity was 40% with EHF-PTA or DP-OAE. Although both EHF-PTA and DP-OAE showed the same sensitivity in detecting ototoxicity, they did not produce the same results in all patients. These two hearing tests could be used to complement one another. Clinicians should use both tests simultaneously in every cycle of chemotherapy to ensure the detection of ototoxicity.

The Evaluation of Minnesota Code in Electrocardioraphic Diagnosis of Ventricular Hypertrophy

Authors evaluated the electrocardiographic criteria of Minnesota Code (III-1, III-2) for the diagnosis of left and right ventricular hypertrophy in 93 cases of healthy peoples, 74 cases of left ventricular hypertrophy and 4 cases of right ventricular hypertrophy and following results were obtained. 1. By left ventricular hypertropy criteria (III-1), there were 5.4% of false positive and 14.9% of false negative cases. 2. By right ventricular hypertrophy criteria III-2), there were 24.7% of false positive and 20.0% of false negative cases. 3. Electrocardiographic diagnosis of ventricular hypertrophy by Minnesota Code (III-1, III-2) were more reliable criteria than many other criteria of ventricular hypertrophy.

Epidemiological Study of Heart Disease in Korea: 5 Year Interval Change

In order to investigate the trend of prevalence of heart disease in Korea, statistical observation was made on 19,239 cases of medical in-patients who were treated in 3 general hospitals, Korea University Hospital, Seoul Red Cross Hospital and Seoul Adeventist Hospital, on 73,484 cases of medical out-patients who were seen at Korea University Hospital and Seoul Adventist Hospital during the period of 5 years, from 1972 through 1976, on 7,746 cases of medical in-patients during the period of 10 years (1967 through 1976), and on 50,083 cases of medical out-patients during the period of 15 years (1962 through 1976) who were treated in Korea University Hospital. The results obtained were as follows. 1. Heart disease was 5.5% (male 5.4%, female 5.7%) of medical out-patients and 16.1% (male 16.7%, female 15.5%) of medical in-patients. 2. The incidence of heart disease was increased with the increase of age in both out-patients and in-patients. The incidences of heart disease in out-patients by age group to the total out-patients of each age group were 1.8% in 15~40 year group, 10.2% in 41~60 year group and 18.4% in over 61 year group, and those in in-patients were 5.0% in 15~40 year group, 24.4% in 41~60 year group and 30.8% in over 61 year group. 3. The incidences of individual heart disease to 4,074 cases with heart disease (male 1,986, female 2,088) of out-patients were as follows. Rheumatic myocarditis was 0.5% (male 0.6%, female 0.5%), mitral valvular disease 8.3% (male 5.8%, female 10.6%), aortic valvular disease 3.1% (male 3.9%, female 2.2%), mitral and aortic valvular disease 0.7% (male 1.3%, female 0.7%), hyper tension 72.0% (male 72.8%, female 71.0%), myocardial infarction 0.7% (male 1.2%, female 0.2%), angina pectoris 2.2% (male 3.1%, female 1.4%), atherosclerotic heart failure 4.5% (male 4.8%, female 4.1%), pericarditis 0.4% (male 0.6%, female 0.3%), idiopathic myocardiopathy 0.5% (male 0.5%, female 0.6%), postpartum myocardiopathy 0.3% in female, cor pulmonale 0.3%(male 0.2%, female 0.4%) and congenital heart disease 1.4% (male 1.8%, female 1.1%). 4. Incidences of individual heart disease to total 3,091 cases with heart disease (male 1,573, female, 1,518) of in-patients were as follows. Rheumatic myocarditis was 0.4% (male 0.5%, female 0.3%), mitral valvular disease 8.1% (male 5.1%, female 11.2%), aortic valvular disease 1.1% (male 1.3%, female 0.8%), mitral and arotic valvular disease 0.3% (male 0.3% female 0.4%), hypertension 69.6% (male 71.3%, female 68.5%), myocardial infarction 2.8% (male 4.3%, female 1.4%), angina pectoris 1.7% (male 2.0%, female 1.3%), atherosclerotic heart failure 7.5%(male 7.7%, female 6.8%), pericarditis 0.8% (male 0.9%, female 0.8%), idiopathic myocardiopathy 1.3% (male 1.3%, female 1.3%), postpartum myocardiopathy 0.7% in female, cor pulmonale 1.5% (male 1.5%, female 1.6%) and congenital heart disease 0.5% (male 0.4%, female 0.5%). 5. There was no significant seasonal variation of the incidences of individual heart diseases. 6. The incidences of rheumatic valvular heart disease, coronary heart disease and congenital heart disease of medical out-putients of Korea University hospital by 5-year-period for 3 consecutive periods (1962 through 1976) were increased and those of hypertension and cor pulmonale were decreased. 7. The incidneces of coronary heart disease and idiopathic myocardiopathy of medical in-patients of Korea University Hospital by 5-year-period for 2 consecutive periods (1967 through 1976) were increased and those of rheumatic myocarditis, hypertension and postpartum myocardiopathy were decreased. There was no change in incidence of rheumatic heart disease including rheumatic myocarditis, and congenital heart disease. 8. The trend of increasing prevalence of coronary heart disease, especially angina pectoris, was noted. Although hypertension was decreased in relative incidence, the total number of patients with hypertension was increased. This seems to suggest that hypertension tends to increase.

Clinical Experience of Etafenone (Baxacor(R)) in the Treatment of Angina Pectoris

The clinical effect of etafenone on 12 cases of angina pectoris(9 males and 3 females with average age of 58.3 years) were studied and following results were obtained: 1. Anginal chest pains were improved after average 9 days (3~15 days) of medication and the dreug was very effective in 41.7%, moderately effective in 33.3% and slightly effective in 25.0% of cases. 2. The ST segment depression of E.C.G. were reduced in 50.0%, improvement of T waves inversion or enlargement of T waves were observed in 66.7% and E.C.G. improvement either ST segment or T wave observed in 75.0% of cases. 3. No side reactions such as hypotension, palpitation, dizziness, headache or gastrointestinal disturbances were seen during the treatement with etafenone.

Clinical Experience of Etafenone (Baxacor(R)) in the Treatment of Angina Pectoris

The clinical effect of etafenone on 12 cases of angina pectoris(9 males and 3 females with average age of 58.3 years) were studied and following results were obtained: 1. Anginal chest pains were improved after average 9 days (3~15 days) of medication and the dreug was very effective in 41.7%, moderately effective in 33.3% and slightly effective in 25.0% of cases. 2. The ST segment depression of E.C.G. were reduced in 50.0%, improvement of T waves inversion or enlargement of T waves were observed in 66.7% and E.C.G. improvement either ST segment or T wave observed in 75.0% of cases. 3. No side reactions such as hypotension, palpitation, dizziness, headache or gastrointestinal disturbances were seen during the treatement with etafenone.