A Case of Infantile Nephrotic Syndrome associated with Neuroblastoma

Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

The Merits of Mannitol in the Repair of Orbital Blowout Fracture

BACKGROUND: One of the main concerns in orbital blowout fracture repair is a narrow operation field, due mainly to the innate complex three dimensions of the orbit; however, a deep location and extensive area of the fracture and soft tissue edema can also cause concern. Swelling of the orbital contents progresses as the operation continues. Mannitol has been used empirically in glaucoma, cerebral hemorrhage, and orbital compartment syndrome for decompression. The authors adopted mannitol for the control of intraorbital edema and pressure in orbital blowout fracture repair. METHODS: This prospective study included 108 consecutive patients who were treated for a pure blowout fracture from January 2007 to October 2012. For group I, mannitol was administered during the operation. Under general anesthesia, all patients underwent surgery by open reduction and insertion of an absorbable mesh implant. The authors compared postoperative complications, the reoperation rate, operation time, and surgical field improvement between the two groups. RESULTS: In patients who received intraoperative administration of mannitol, the reoperation rate and operation time were decreased; however, the difference was not statistically significant. The total postoperative complication rates did not differ. Panel assessment for the intraoperative surgical field video recordings showed significantly improved vision in group I. CONCLUSIONS: For six years, mannitol proved itself an effective, reliable, and safe adjunctive drug in the repair of orbital blowout fractures. With its rapid onset and short duration of action, mannitol could be one of the best methods for obtaining a wider surgical field in blowout fracture defects.

Application of Mini-abdominoplasty after Conservative Excision of Extensive Cesarean Scar Endometriosis

Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a 9x6 cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather than extensively to prevent incisional hernia considering the benign nature of the tumor and the low possibility of recurrence because the patient's age was near menopause, along with simultaneous bilateral salpingo-oophorectomy that was performed in this case. On reconstruction, mini-abdominoplasty was adopted to avoid possible wound complications and cosmetic deformities. The patient was satisfied with the cosmetic results, and neither recurrence nor functional problems occurred during the 1-year follow-up period. Plastic surgeons should keep in mind the possibility of cutaneous endometriosis in an abdominal mass of a female of reproductive age with a previous history of pelvic or intra-abdominal surgery. An optimal result from oncological, functional, and cosmetic standpoints can be achieved with conservative excision followed by mini-abdominoplasty of extensive Cesarean scar endometriosis.

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.

Squamous Cell Carcinoma and Basal Cell Carcinoma Simultaneously Arising in a Nevus Sebaceus: A Case Report

PURPOSE: Nevus sebaceus is a congenital hamartomatous lesion, typically involving head and neck. Various benign and malignant neoplasms can develop in association with nevus sebaceus. We report a case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma in nevus sebaceus. METHODS: A 73-year-old man presented with erythematous to black verrucous nodules on the right subauricular area. The upper part was accompanied with inflammation and ulceration, and no specific findings suspicious for malignant degeneration were found in the lower part preoperatively. The mass was totally excised and the defect was directly closed. Lymph nodes were not involved on concomitant neck dissection. RESULTS: Histopathologic examination confirmed the presence of squamous cell carcinoma in the upper part and basal cell carcinoma in the lower part of a nevus sebaceus. Negative margins were achieved on resection. No clinical problems were found during the 3-month follow-up period. CONCLUSION: We experienced a rare case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma within the same nevus sebaceus. Because patients with nevus sebaceus have risk of malignant changes, surgical excision and work-up for recurrence and metastasis should be considered in suspicious cases. And even in a totally asymptomatic case, the possibility of occult secondary cancer should be informed before surgery in aged patients.

The syndrome of inappropriate antidiuretic hormone secretion with olfactory neuroblastoma: A case report / 대한내과학회지

We report a 62-year-old man with histologically confirmed olfactory neuroblastoma who also had the syndrome of inappropriate antidiuretic hormone secretion (SIADH). An olfactory neuroblastoma is a rare malignancy of the nasal cavity or paranasal sinuses and is rarely associated with excess hormone syndromes. The ectopic production of antidiuretic hormone (ADH) by a tumor is most often due to a small cell carcinoma of the lung, while less common causes include an olfactory neuroblastoma. To our knowledge, this is the first reported case of SIADH secondary to an olfactory neuroblastoma in Korea.

Evaluation and Prevention of Gentamicin-induced Vestibulotoxicity in Rabbits Using Off-Vertical Axis Rotation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purposes of this study was to investigate the characteristics of gentamicin-induced vestibulotoxicity of s otolith organs by assessing the results of earth vertical and the off-vertical axis rotation tests with a morphologic study. MATERIALS AND METHODS: Rabbits were grouped into two groups, ototoxic and ototoxic prevention group. Vestibulotoxicity was induced by injecting gentamicin (GM) into the peritoneum. Prevention of the vestibulotoxicity was studied by injecting NMDA receptor inhibitors (MK-801), iron chelating agents (deferoxamine) peritonially, and osmotic pumps filled with neurotrophic factors (GDNF, BDNF), respectively. The animal rotation system was designed to rotate the animal sinusoidally or in velocity step (constant velocity) rotation. Off-vertical rotation was applied to evaluate the otolithic function. Scanning electron microscopy were examined for the structural changes of the otolithic organs. RESULTS AND CONCLUSIONS: GM-induced vestibulotoxicity was confirmed by gain decreasing in the earth vertical SHA rotation test and bias decreasing in the off-vertical rotation test. However, changes in modulation was not definite. Bilateral prevention of GM-induced vestibulotoxicity was confirmed by systemic injection of deferoxamine and MK-801, and characteristics of unilateral prevention was confirmed by local application of the neurotrophic factors using osmotic pumps. In the SEM study, the GM-induced hair cell damages of the vestibule were identified, which was prevented by the preventive drugs. The reduction of bias value without change of modulation was comparable with the reduction of gain in the earth vertical axis rotation after GM-induced vestibulotoxicity.

Nonsecretory Multiple Myeloma associated with Immune Thrombocytopenia and Complicated by Malignant Ascites / 대한혈액학회지

Thrombocytopenia is frequently seen in patients with multiple myeloma when most often the etiology is either chemotherapy induced marrow suppression or bone marrow replacement by myeloma cells. But immune thrombocytopenia has only rarely been documented in patients with multiple myeloma. Also ascites caused by peritoneal infiltration with myeloma cell rarely develops in patients with multiple myeloma. We report a patient with nonsecretory multiple myeloma associated with immune thrombocytopenia and complicated by malignant ascites and periumbilical nodules.

Nonmyeloablative Stem Cell Transplantation in a Patient with Refractory Acute Myeolgeous Leukemia with Central Diabetes Insipidus / 대한혈액학회지

A 31-year-old man presented fatigue, polydipsia and polyuria. He was diagnosed as acute myelogenous leukemia (AML) FAB-M1, and a water deprivation test confirmed central diabetes insipidus (DI). A sella magnetic resonance imaging showed the thickening of pituitary stalk with contrast enhancement suggesting leukemic infiltration. He was treated with remission induction chemotherapy including cytosine arabinoside and idarubicin, and concurrent intrathecal methotrexate, cytosine arabinoside and hydrocortisone. But he was not achieved a remission. Reinduction chemotherapy was also failed to induce remission. He underwent a non-myeloablative allogeneic he matopoietic stem cell transplantation (NST) from HLA one antigen mismatched sibling donor for refractory AML. After transplantation, he had no evidence of leukemia and DI, He showed complete conversion of donor chimerism. By day 7 after NST, desmopressin (DDAVP) was no longer required and a follow-up at 9 months he has no evidence of relapse. We report a rare case recovered from diabetes insipidus associated with acute myelogenous leukemia after NST in Korea.

Restoration of Volume after Partial Resection of Tongue in Rabbit: Comparative Analysis according to Scalpel, Electrocautery and Diode Laser with or without Closure / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Performing oncologically safe, wide surgical excisions and postoperative volumetric restoration of resected tongues to gain functional recovery are contrary problems to deal with in performing glossectomy. There is no report about the volumetric restoration of a resected tongue according to resecting devices until now. The purpose of this study is to clarify the difference of postoperative volumetric changes of a resected tongue using a scalpel, electrocautery and laser with or without closure. MATERIALS AND METHOD: We used 12 rabbits for each group according to the resecting devices and also equally divided each group according to the closure or non-closure method. The volumetric changes of a resected tongue were measured by the Archimedes principles in one, two, three, and six months postoperatively. RESULTS: Regardless of resecting devices, the postoperative volume of a resected tongue was gradually increased as elapsed time. The nonclosure method was better than the closure method with respect to the volumetric restoration of the resected tongue regardless of the resecting devices, but there was no statistical significance of volumetric restoration between the closure and nonclosure methods in each group (p>0.05). The superior resecting device for the volumetric restoration of a resected tongue was diode laser, especially compared to electrocautry, in both closure and nonclosure method (p<0.05). CONCLUSION: The volumetric restoration after resection of the tongue using laser and nonclosure method are superior to electrocautery and to the closure method, respectively.

The frequency of thiamine deficiency in chronic alcoholics and in patients at a long-term care facility / 대한내과학회지

BACKGROUND: As socioeconomic status has improved, malnutrition has become rare in Korea and generally it is no longer considered as a serious problem in medical practice. However, contrary to the above general belief we managed four patients with beriberi in 1999 and it became apparent that malnutrition might remain a problem in certain groups of patients. In this study, we assessed the nutritional state, especially with respect to thiamine deficiency, in chronic alcoholics and in patients residing at a long-term care facility (LTCF). METHODS: Fourteen chronic alcoholic patients and twenty patients being hospitalized in a long-term care facility were assigned as the study groups. The subjects' mean ages and standard deviations were 48.9+/-10.2 and 50.6+/-6.7, respectively. Medical records were reviewed to determine other aspects of their nutritional status and their dietary patterns. Ten peoples who visited the health promotion center at Inha University Hospital, for routine check-ups were allocated to the control group. Blood total thiamine levels were measured by high-performance liquid chromatography. RESULTS: Body mass indices were significantly lower in chronic alcoholics and in patients at the LTCF than in the control group (p=0.0065). Serum albumin levels were within the reference range in all three groups, but were significantly lower in patients at the LTCF than in the control group (p=0.0013). Moreover, no difference was detected between the alcoholic group and the control group in terms of thiamine levels. However, the mean thiamine level in patients at the LTCF was statistically lower than that of the control group and four (20%) patients in the LTCF group showed subnormal blood thiamine levels. The thiamine level tended to decrease with age in both alcoholics and patients at the LTCF. No correlation was found between thiamine level and the other variables examined, namely, hospital stay, body mass index, and serum albumin level. CONCLUSION: A considerable portion of patients in a long term care facility showed thiamine deficiency, however, no evidence of thiamine deficiency was found among alcoholics. This result suggests that thiamine deficiency in patients at long-term care facility may be more prevalent and that thiamine supplementation may be warranted, especially for those with other thiamine deficiency risk factors.

A Case of Idiopathic Hypereosinophilic Syndrome Manifested by Massive Pericardial Effusion

Idiopathic hypereosinophilic syndrome is a state of marked eosinophilia of unknown cause accompanied by multiple organ involvement. Any organ may be involved including bone marrow, heart, lung, gastrointestinal tract, liver, kidney and the nervous system. The common cardiac manifestations of hypereosinophlic syndrome are myocarditis, endocardial fibrosis, formation of mural thrombi, valvular hearat disease, restrictive cardiomyopathy and congestive heart failure. We report a case of a 61-year-old man with idiopathic hypereosinophilic syndrome manifested by myocarditis and severe pericardial effusion on transthoracicechocardiography that was successfully treated by pericardiocentesis and on-going steroid therapy.

Traumatic Facial Nerve Palsy: CT Patterns of Facial Nerve Canal Fracture and Correlation with Clinical Severity

PURPOSE: To analyse the patterns of facial nerve canal injury seen at temporal bone computed tomography (CT) in patients with traumatic facial nerve palsy and to correlate these with clinical manifestations and outcome. MATERIALS AND METHODS: Thirty cases of temporal bone CT in 29 patients with traumatic facial nerve palsy were analyzed with regard to the patterns of facial nerve canal involvement. The patterns were correlated with clinical grade, the electroneurographic (ENoG) findings, and clinical outcome. For clinical grading, the House-Brackmann scale was used, as follows: grade I-IV, partial palsy group; grade V-VI, complete palsy group. The electroneuronographic findings were categorized as mild to moderate (below 90%) or severe (90% and over) degeneration. RESULTS: In 25 cases, the bony wall of the facial nerve canals was involved directly (direct finding): discontinuity of the bony wall was onted in 22 cases, bony spicules in ten, and bony wall displacement in five. Indirect findings were canal widening in nine cases and adjacent bone fracture in two. In one case, there were no direct or indirect findings. All cases in which there was complete palsy (n=8) showed one or more direct findings including spicules in six, while in the incomplete palsy group (n=22), 17 cases showed direct findings. In the severe degeneration group (n=13), on ENog, 12 cases demonstrated direct findings, including spicules in nine cases. In 24 patients, symptoms of facial palsy showed improvement at follow up evaluation. Four of the five patients in whom symptoms did not improve had spicules. Among ten patients with spicules, five underwent surgery and symptoms improved in four of these; among the five patients not operated on, symptoms did not improve in three. CONCLUSION: In most patients with facial palsy after temporal bone injury, temporal bone CT revealed direct or indirect facial nerve canal involvement, and in complete palsy or severe degeneration groups, there were direct findings in most cases. We believe that meticulous analysis and symptom correlation of the fracture patterns seen in facial nerve canal injury in patients with traumatic facial nerve palsy is helpful for treatment planning and prognosis.

Evaluation of Vestibulo-spinal Reflex Using Modified Romberg Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Romberg test is a simple, inexpensive modality to test the vestibulo-spinal reflex. However, it is not a quantitative measure and has low sensitivity and specificity. We investigated the effectiveness of the modified Romberg test in evaluating equilibrium ability in dizzy patients by comparing it with the computerized dynamic posturography. MATERIALS AND METHODS: The study was conducted on 63 patients with various degrees of dizziness. Computerized dynamic posturography(CDP) was performed and equilibrium ability was measured with the modified Romberg test. Modifications were made in two ways : heel-to-toe standing(test 1) and standing on sponge(test 2). RESULTS: Correlation coefficients between the modified Romberg test and the vestibular dysfunction score of CDP were 0.62 and 0.52, respectively, and they were statistically significant(P<0.01). The Receiver Operating Characteristics(ROC) curve showed that the area index of tests 1 and 2 were 0.86 and 0.78, respectively. CONCLUSIONS: The modified Romberg tests showed fairly good correlation with the vestibular dysfunction score of CDP. Further modifications are required to use the modified Romberg test as an accurate diagnostic tool in the evaluation of dizzy patients.

Clinical Analysis of Childhood Vertigo / 대한소아신경학회지

PURPOSE: Vertigo and dizziness are not common complaints in childhood, but are present more often than formerly thought. A detailed interview and otoneurological examination are important for reaching a specific diagnosis and treatment. The purpose of our study was to obtain our own etiological, clinical and diagnostic statistics, and to review the major related pathologies. METHODS: We investigated eighty-five children who visited Dankook University Hospital with a chief complaint of vertigo. Presenting symptoms, the result of diagnostic tests, and etiologic diagnoses were evaluated. RESULTS: Benign paroxysmal vertigo in childhood was the most common etiology of childhood vertigo accounting for about 38.8%, and migrainous vertigo and post-traumatic vertigo were present in 17.6% and 12.9% respectively. In vestibular function testings, electronystagmography and rotating chair test were abnormal in 11.2% and 21.2%, and the score of sensory organization test in posturography was lower than 50 in 44.4%. Other clinical diagnostic tests were informative for elucidation of individual etiologies. CONCLUSION: Benign paroxysmal vertigo in childhood and migrainous vertigo were the most common etiologies in childhood vertigo, with the former more common in under 12 years and the latter more common in over 12 years. Vestibular function tests were not so informative in diagnostic approach of childhood vertigo.

Changes of Vestibulo-Ocular Reflex and Its Relation with Auditory functions in Chronic Renal Failure Patients Receiving Hemodialysis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sensorineural hearing loss and vestibular dysfunction are frequently found in patients receiving hemodialysis with chronic renal failure (CRF). However, the responsible etiologic factors, prevalence, relationship between auditory and vestibular dysfunction still remains unclear. The purpose of this study is to assess vestibular dysfunction and to investigate the relation between changes in vestibulo-ocul ar reflex (VOR) and auditory dysfunction in CRF patients receiving hemodialysis. MATERIALS AND METHODS: Thirty-five patients (70 ears) receiving hemodialysis with chronic renal failure were selected. Pure tone audiometry, monothermal caloric test, and velocity step rotation test were performed to assess the audio-vestibular function of the patients. Thirty normal controls were selected for comparison of vestibular function tests. RESULTS: Twenty-four (34%) out of 70 ears had pure tone average (PTA) of 25dBHL or more. The average peak velocity of caloric test and the value of slow cumulative eye position (SCEP) of velocity step test in the patient group were 18.7+/-10.5 d/sec and 376.9+/-170.0 degree, respectively. These values were significantly different from those of normal controls whose average peak velocity of caloric test and SCEP values of velocity step test were 25.3+/-6.0d/sec and 586.3+/- 207.3 degree, respectively(p<0.05). The results of caloric test and velocity step test in the patients with PTA of 25dBHI, or more were 10.2+/- 6.0 d/sec and 224.5+/-143.0 degree, respectively, while those of the patients with PTA of less than 25dBHL were 22.7+/-9.7 d/sec and 437.9+/-140.5 degree, respectively. These two groups showed a statistically significant difference(p<0.05). CONCLUSION: The patients under hemodialysis with CRF exhibited reduced vestibular function compared to normal control group.

A Comparative Acoustic Study of Voice Rehabilitation After Total Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Acoustic parameters of maximal phonation time, sound intensity, fundamental frequency, voice range, jitter and shimmer were analyzed in order to evaluate voice quality and differences among esophageal speech (ES), tracheoesophageal shunt speech (TES), pneumatic aid speech (PA), electrolaryngeal speech (EL) according to phonetic rehabilitation methods in 16 cases of laryngectomees. MATERIALS AND METHODS: We acquired acoustic data on alaryngeal voice by different methods, and analysed each of those using specially designed programs (Laryngeal analyser V1.0 base on Matlab V5.0). RESULTS: Maximal phonation time was significantly longer in TES voice and PA speech than in ES voice (p<0.05). Jitter and shimmer were significantly regular and stable in the EL and PA speech than in the ES and TES voice (p<0.05). Voice range was significantly wider in TES voice and PA speech than in EL and ES voice (p<0.05). In two cases capable of bi-modal speech of ES and TES voice, maximal phonation time was longer with wider voice range in TES voice than in ES voice. Jitter and shimmer were regular and stable in ES voice than in TES voice. CONCLUSION: PA speech displays phonetically more natural laryngeal speech than other rehabilitation methods. But this methods is inconvenient and cosmetically unacceptable, because patients have to bite intraoral vibrator in the patient's mouth. So, we recommend TES voice rather than ES voice, without the use of speech-making device such as EL and PA speech.

Cardiogenic Dizziness Treated with Cardiac Pacemaker: Reports of Four Cases / 대한이비인후과학회지

Decreased cardiac output can present dizziness that is usually described as light-headed sensation of an impending faint. It is often associated with a feeling of unsteadiness or even of falling. Cardiogenic dizziness should always be included as a differential diagnosis especially when examining older patients with dizziness. It is obviously important to identify patients with heart related presyncope or syncope, because many of them have serious underlying cardiac diseases and are at risk for sudden death, if not appropriately treated. Four patients with dizziness were diagnosed at the University Hospital as having dizziness originated from decreased cardiac output. Two had the sick sinus syndrome, one had a complete AV block and one had a congestive heart failure with 2nd degree AV block. After evaluation and cardiac pacemaker implantation, they all became free of dizziness. We present these cases with some review of cardiogenic dizziness.

Hearng loss in chronic renal failure patients / 대한내과학회지

OBJECTIVES: Hearing loss, mainly a sensorineural hearing loss (SNHL), was frequently observed in patient with chronic renal failure. Although several causes and prevalence of this hearing loss had been proposed, the etiology and prevalence are still controversial. The purpose of the present study was another study to determine the prevalence, type and comparative degree of hearing loss in chronic renal failure according to various parameters. METHODS: Subjects for this study were 39 patients with hemodialysis and 10 chronic renal failure patients before hemodialysis. Pure tone audiometry was performed and pure tone average(PTA) was estimated. At same time, pure tone threshold were estimated at the range from 250 to 500(low frequency range), from 1000 to 2000(middle frequency range) and from 4000 to 8000 Hz(high frequency range). Significant hearing loss of PTA as well as the significant loss in pure tone threshold of each frequency range was defined when the loss of hearing ability was 25dB more than the normal value. The effect of alteration in age, sex, hemoglobin, lipid profile, duration of hemodialysis, underlying diseases and ototoxic drugs were evaluated. RESULT: 1) The main type of hearing loss was SNHL and it was asymptomatic and progressive. The prevalence of SNHL by means of PTA was 76% in the patient with chronic renal failure. The SNHL of high frequency range(89%), SNHL of middle frequency range(18%) and SNHL of low frequency range (45%) were observed on the basis of the pure tone threshold. 2) There was no significant difference of SNHL according to various parameters of sex, hemoglobin, lipid profile, BUN, and underlying diseases except age. 3) The patients under hemodialysis exhibited the more SNHL over all frequency ranges than those without hemodialysis and there was the more SNHL in patients of more than 2 years of hemodialysis and those of less than 2 years of hemodialysis 4) Furosemide was significantly ototoxic in patients with chronic renal failure. CONCLUSION: The type of hearing loss was mainly sensori-neural and high tone loss. The degree was slight to moderate. The prevalence was the higher than expected. Regular hemodialysis treatment seems to affect hearing loss during even 2 years of treatment. Therefore, hearing loss appeared to be related to the duration of hemodialysis. The more precise and regular audiometric monitorings were recommanded in hemodilalysis patients.

Adaptation of the Vestibulo-Ocular Reflex to Concave Spectacle Lens / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Vestibulo-ocular reflex (VOR) is the mechanism for the production of rapid compensatory eye movement during head movements. VOR gain can adapt to a change in visual stimulation, which is called adaptive plasticity. To investigate the adaptation of VOR to concave spectacle lens, the authors compared the diopters with VOR gain changes. MATERIALS AND METHODS: Calibration and sinusoidal harmonic acceleration (SHA) rotation tests at 0.01, 0.04 and 0.16 Hz were performed on 24 volunteer subjects wearing myopic lenses, with glasses on and off. RESULTS: VOR gains of patients with glasses-on were significantly greater, compared with those without glasses. Correlation between diopters and gain change ratio was significant, especially at low frequencies. CONCLUSION: Long-term wearing of myopic lenses induced VOR gain reduction, which is proportioned to the diopter of the lenses.