Comparison of intratympanic and intravenous dexamethasone treatment on sudden sensorineural hearing loss with diabetes.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of intratympanic administration of dexamethasone (IT-DEX) treatment on sudden sensorineural hearing loss (SSNHL) patients with diabetes by comparing the results with intravenous administration of dexamethasone (IV-DEX) treatment. STUDY DESIGN: Comparative study. SETTING: University hospital and affiliated hospital. PATIENTS: Ten sequential SSNHL patients with diabetes receiving IT-DEX and 21 sequential SSNHL patients with diabetes receiving IV-DEX. Patients with low tone hearing loss were excluded. INTERVENTION: In the IT-DEX group, two methods were applied to deliver DEX (4 mg/ml): injection through a perforation made by laser-assisted myringotomy or through a tympanostomy tube. IT-DEX administration was performed on 8 sequential days. In the IV-DEX group, DEX was administrated intravenously starting from an amount of 8 mg/d followed by taped doses for 10 days. MAIN OUTCOME MEASURES: Preprocedure and postprocedure hearing levels and complications. RESULTS: In the IT-DEX group, the average hearing level before the treatment was 79 dB. Overall, all 10 patients showed improvement of more than 10 dB in the pure-tone audiogram, with a mean improvement of 41 dB. Seven patients (70%) demonstrated successful results, and four recovered completely. In the IV-DEX group, 14 (67%) of the 21 patients showed improvement of more than 10 dB with a mean improvement of 25 dB. Thirteen patients (62%) demonstrated successful results. Free blood sugar during and after the IT-DEX treatment remained below the pretreatment levels, whereas four patients in the IV-DEX group demonstrated worsening of the hyperglycemia. CONCLUSION: IT-DEX treatment is at least as effective as IV-DEX treatment for SSNHL patients with diabetes.

[Prediction of the date of Japanese cedar pollen release in Aomori Prefecture].

When we treat patients with pollen allergy, we require correct information about pollen release. The total count of pollen and the date of first pollen release are strongly influenced by local weather conditions, so we wanted to predict local pollen release. Patients have degrees of sensitivity to pollen, with symptoms triggered in some cases by only small amounts. Therefore, we wanted to determine the previous dates of first pollen release (A), the first of two consecutive dates when one (count/cm2) or more grains were released (B), and the first of two consecutive dates when ten (count/cm2) or more grains were released (C). Aomori Prefecture has three different weather zones because it is surrounded by three oceans the Sea of Japan, the Pacific Ocean, and Mutsu Bay. We predicted pollen release in the major cities--Aomori, Hirosaki, and Hachinohe. Using nine years (1996-2004) of temperature data for each city from January 1 through February 1, we recorded the number of days in which the daily highest temperature was higher than each of five set temperatures (0 degree C, 1 degree C, 2 degrees C, 3 degrees C, 4 degrees C) up to the dates of A, B, and C. Multiple recordings were made for each year with the initial date of recording staggered at 10-day intervals. We then calculated the standard deviation and the efficient of variation of total days and totals of temperatures over set temperatures. For Aomori, results indicated that A was predicted as day 19 with temperatures over 4 degrees C after January 21. B was day 23 over 4 degrees C after January 21. C was the day 31 with over 4 degrees C after January 21. For Hirosaki, A was expected to be day 26 having temperatures over 0 degrees C after February 1. B was day 21 over 3 degrees C after February 1. C was day 30 over 3 degrees C after January 21. For Hachinohe, A was day 34 with temperatures over 0 degrees C after February 1. B was day 33 over 1 degree C after January 21. C was day 27 over 4 degrees C after January 21. We examined the day of pollen release in 2005.

[Prediction of Japanese cedar pollen emission in a snowy area--surveillance in Hirosaki City].

Japanese cedar is the most common pollinosis allergen in Japan. Predictions of total pollen counts and the first 2 or more days of the Japanese cedar pollen season are beneficial to patients. We developed predictive methods for those 2 factors in Hirosaki. We conducted an atmospheric Japanese cedar pollen survey from 1996 to 2002 in Hirosaki and compared yearly data with the male flowering index counted in 50 cedar trees in the preceding autumn. The male flowering index correlated highly positively with total cedar pollen counts in regression analysis, indicating its usefulness in predicting total pollen counts. Although the number of days from January 1 to the first day of continuous pollen emission showed no correlation with the cumulative maximum temperature during these days, the number of days from the day of first detection of pollen emission (minimum of 1 particle per sq. cm) to the first day of continuous pollen emission correlated highly with the cumulative maximum temperature and cumulative amount of snowfall on these days, suggesting that it is possible to predict the first day of continuous pollen emission by the cumulated daily maximum temperature after the day of first detection of pollen emission.