Three Dimensional Analysis of Caloric, Spontaneous, Positional, Positioning and Post Head Shaking Nystagmus in Bilateral Vestibulotoxic Cats / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Vestibular toxicity can be usually monitored by a caloric test, but measuring eye movements including nystagmus is also helpful in the evaluation of vestibulotoxic process. To understand the vestibular signs during bilateral vestibulotoxic process, we observed three dimensional serial changes of eye movements and the results of caloric test in cats using a magnetic search coil system. MATERIALS AND METHODS: Three-dimensional (3-D) eye movement responses to ice water caloric stimulus and spontaneous, positional, positioning, and post head shaking nystagmus in five cats were serially evaluated at 3, 7, 10, 14, 21, 28 days, 2, 3, 4, 5, 6 months after inducing bilateral vesitibulotoxicity by subcutaneous injection of streptomycin. Histologic changes of vestibular system were also observed. RESULTS: Bilateral vestibulotixicity which showed no response to ice water caloric stimulus was induced within 2 weeks with streptomycin injection. Positional, positioning and post head shaking nystagmus were present during vestibulotoxic process. Caloric nystagmus did not reappear within 6 months and histologic finding in crista ampullaris of lateral semicircular canal showed marked degeneration of the hair cells and nerves. CONCLUSION: Observation of positional, positioning and post head shaking nystagmus as well as ice water caloric test will be helpful to monitor vestibulotoxic process.

Crohn's Disease with Oral and Tonsillar Ulceration / 대한이비인후과학회지

Granulomatous lesions of the small bowel and colon are common in Crohn's disease, with other sites of involvement relatively infrequent. Nevertheless, Crohn's disease is frequently described as a disease of the entire gastrointestinal tract, although the involvement of the oral mucosa and tine tonsil with Crohn's disease has been a rarely noted extraintestinal manifestation of the disease. This report describes one such case. The history, physical examination, endoscopic findings, histological findings, and response to treatment are presented.

Experimental Immune-Mediated Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In 1979, MaCabe described the autoimmune sensorineural hearing loss generally characterized by bilateral progressive sensorineural hearing loss over weeks to months. He also described steroid responsiveness of heaing loss. Since then, numerous attempts have been tried to investigate autoimmune inner ear disease. But, there is insufficient information concerning pathophysiology and no reliable laboratory tests are available for diagnosis. In this study, we immunized healthy rats with bovine brain antigen, and monitored auditory brainstem response threshold shifts and serum antibody titer especially antibody to 68 kD protein, and observed histologic changes to develop animal model and to investigate pathophysiology of inner ear autoimmunity. MATERIALS & METHODS:We used 15 female Wistar rats weighing 200 g to 250 g. Three of them (as control group) were immunized with bovine serum albumin and the rest were weekly immunized with bovine brain antigen 3 times. After the antigen challenges, animals were sacrificed at 1st, 2nd, 4th or 8th week after collection of serum and ABR test. Hearing was evaluated by ABR prior to each immunization and at 1st, 2nd, 3rd, 4th, 6th or 8th week following immunization. Collected sera were analyzed by Western blotting immunoassay against fresh bovine brain antigen preparation. RESULTS: On ABR, hearing threshold shifts of 10 to 40 dB were recorded and shifts of greater than 20 dB were recorded in 8 ears (33.3%) of 24 ears. On Western blot assay, a band at 68 kD M.W. was observed with high binding activity at 1st week through 4th week following immunization. Cellular infiltration was observed in the are as adjacent to the spiral modiolar venules in the cochlear modiolus and in the spiral ganglion cells in a scattered pattern. CONCLUSION: These results suggest that bovine brain antigen can induce autoimmune inner ear disease in experimental animals and that inner ear autoimmunity may play an important role in the development of inner ear disorders and hearing loss.

A Case of Huge Cholesterol Granuloma Cyst in Temporal Bone with Intracranial Extension / 대한이비인후과학회지

Cholesterol granuloma is thought to arise as the consequence of obstruction of the air cell system. Once the ventilation is blocked, negative pressure builds with mucosal hemorrhage and blood extravasation into the air cell system. And the catabolism of blood releases cholesterol, hemosiderin, lipids and fibrin. It is the foreign body reaction of these products that leads to cholesterol granuloma and cholesterol granuloma cyst formation. The cholesterol granuloma and cholesterol granuloma cyst may develop in any portion of the pneumatic system of the temporal bone and small lesions are commonly encountered in the middle ear and mastoid air cells. But, huge cholesterol granuloma cyst is a unusual lesion and cholesterol granuloma cyst with extensive temporal bone destruction and intracranial extension has been rarely reported. Recently we experienced a case of huge cholesterol granuloma cyst with intracranial extension in a 38-year-old female, and report this case with review of literatures.

A Prevalence Study of Otitis Media with Effusion in Kindergarten Children in Puchun / 대한이비인후과학회지

The prevalence and related diseases of otitis media with effusion(OME) which is a very common disease in infants and young children were investigated in a group of 3 to 6 year old children. The study population includes 374 children with 185 boys and 189 girls enrolled in 7 kindergartens in Puchun city. The middle ear status was assessed by combination of findings of otomicroscope, pneumatic otoscope, impedence audiometry. The related diseases were evaluated by radiologic findings and questionnare with statistic analysis. Fifty-nine children were considered to have OME(prevalence: 15.8%) with peak at 3 years of age(30.6%). Of the 59 children with OME, fifty-four percent had bilateral involvement and all the remainder had unilateral involvement. The risk for otitis media with effusion increased in children with adenoid enlargement, tonsillar enlargement, and paranasal sinusitis, and this was confirmed to be statistically significant(p<0.01).