Diagnostic Role of Parotid Computed Tomography for Identifying Sjögren’s Syndrome / 대한이비인후과학회지

Background and Objectives@#Sjögren’s syndrome (SS) is an autoimmune inflammatory disorder of exocrine glands characterized by dry mouth and eye. Recently, ultrasonography has become a valuable tool for the assessment of salivary gland involvement in SS although studies on the usefulness of salivary gland CT is rare. In this regard, we evaluated the diagnostic accuracy of parotid gland CT for SS.Subjects and Method A total of 91 patients with sicca symptoms took a parotid CT, a serology test, an ophthalmologic examination and a minor salivary gland biopsy. At the end, as a standard, we diagnosed the primary SS according to the new 2016 American College of Rheumatology/ European League Against Rheumatism classification criteria. The diagnostic value of parotid CT was compared by the McNemar test. @*Results@#Of the total of 91 patients with parotid CT, 37 (40.7%) patients met the SS classification criteria. On the parotid CT, heterogeneity of the parotid gland has the sensitivity of 74.1%, specificity of 70.3%, and accuracy of 71.4%. The abnormal fat tissue deposition showed the sensitivity of 74.1%, specificity of 81.3%, and accuracy of 79.1%. Diffuse calcification was seen in 1/91 SS patients (sensitivity 3.7%, specificity 100%, accuracy 71.4%). @*Conclusion@#Parotid CT is helpful for the diagnosis of SS. The presence of heterogeneity and fat tissue deposition are highly sensitive for the accuracy of SS. Diffuse calcification in bilateral parotid glands is highly specific for SS.

The Factors Influencing the Accuracy of Head PositionDuring Canalith Reposition Procedure Using 9 AxisInertial Sensor / 대한이비인후과학회지

Background and Objectives@#The canalith reposition procedure (CRP) is used for the treatment of benign paroxysmal positional vertigo (BPPV) where the accuracy of position may affect the therapeutic efficacy. We investigate the accuracy of head position in CRP and its influencing factors during the procedure by measuring the position using inertial sensors and three dimensional remodeling.Subjects and Method We included 28 patients who were diagnosed as BPPV. To evaluate the accuracy of the CRP, we used the inertial sensor on the patient’s goggle used for videonystagmography. We evaluated the accuracy of the treatment compared to the textual treatment used during CRP. We also evaluated patient factors that affected the accuracy of head position as well as analyzing the correlation between the error rate and the successful treatment rate. @*Results@#While the average error rate was 12.6±5.8% for the PSCC group, it was 10.2±5.2% for the lateral semicircular canal (LSCC) group. For the posterior semicircular canal (PSCC) the group with body mass index (BMI), less than 25 patients had the lower error rate than the group with BMI greater than 25. There was no significant differences regarding the error rate according to BMI or age in the PSCC group. There is no significant differences regarding the error rate between those treated within 1 week and those over 1 week. For the LSCC delayed treatment group, there was no significant differences of error rate between the 1st and 2nd maneuver at each position. @*Conclusion@#For the Epley maneuver, the error rate of patients with high BMI is higher than those with low BMI. When the repeated barbeque maneuver was conducted, patients could have a more accurate position due to the learning effect. Care should be taken to ensure accurate CRP by considering various factors.

Clinical Usefulness of Video Head Impulse Test-Comparison of Bithermal Caloric Test and Bedside Head Impulse Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Video head impulse test system (vHIT) is an easy-to-use test and there are numerous studies showing its efficacy. The aim of the study was to evaluate the clinical usefulness of vHIT as an initial test in determining vestibular hypofunction in patients with dizziness. SUBJECTS AND METHOD: The study recruited 103 outpatients who visited our ear clinic with dizziness. We performed both bedside head impulse test (bHIT), vHIT and bithermal caloric tests for 103 patients. Both bHIT and vHIT were consecutively performed in each subject on the same day by the same examiner. RESULTS: The sensitivity of bHIT and vHIT was determined based on the bithermal caloric test results, which showed that vHIT was more sensitive than bHIT. There was a significant negative correlation between vHIT gain and canal paresis (p < 0.05). Results of some patients indicated dissociation between vHIT and caloric test. CONCLUSION: T here is a significant correlation between the results of vHIT and caloric test. Although vHIT does not replace the caloric test, it would be useful to evaluate the initial vestibular loss in patients with dizziness.

Would medical students enter an exclusion zone in an infected district with a high mortality rate? An analysis of book reports on 28 (secondary publication) / 보건의료교육평가

This study aimed to ascertain whether medical students would enter a closed area where there was a raging epidemic of an infectious disease with a high fatality rate, and includes reasons for the students entering or refusing to enter. Participants included 50 second-year medical students. They were assigned to read a novel entitled 28, written by Youjeong Jeong, and discuss it in groups. Using their book reports, their decisions of whether or not to enter Hwayang, the city from the novel, and the reasons for their decisions were analyzed; we furthermore investigated the factors affecting their decisions. Among the 50 respondents, 18 students (36%) answered that they would enter, and the remaining 32 students (64%) answered that they would not enter the zone. The reasons given for entering were responsibility (44%), sense of ethics (33%), social duty (17%), and sense of guilt (6%). The reasons the students provided for not entering were inefficiency (44%), worry regarding family (28%), needlessness of sacrifice (19%), and safety not ensured (9%). Students who had four or fewer family members were more likely to enter Hwayang than were students who had five or more family members (odds ratio, 1.85). Students who had completed over 100 hours of volunteer work were more likely to enter Hwayang than were students who had volunteered less than 100 hours (odds ratio, 2.04). Owing to their "responsibility" as a doctor, 36% of medical students answered that they would enter an exclusion zone in an infected district with a high fatality rate. However, 64% answered they would not enter because of "inefficiency." For the medical students it is still a question 'To enter or not to enter?'