Development and first evaluation of an attractant impregnated adhesive tape against blood-sucking flies.

Stable flies are one of the most important arthropod pests of livestock that reduce cattle weight gain and milk production leading to annual economic losses in excess of $2 billion to the US cattle industry. The host-seeking behavior is primarily mediated by associated odors from stable fly larval development environments and host animals. The present paper reports the development and evaluation of attractant-impregnated adhesive tapes to reduce stable fly attacks on cattle. Laboratory bioassays showed that only m-cresol impregnated adhesive tapes caught significantly more stable flies (16 ± 1) than the control tape without attractant added (7 ± 1), with a 77% fly recapture rate. Attractant-impregnated adhesive tapes deployed in cattle feedlots showed significant impacts in reducing fly population, with a total of one million stable flies captured over a period of three weeks (mean catches from 57 596 to 102 088 stable flies per trap per week). It further relieved cattle stress with a significant reduction of biting fly avoidance behavior, (6 ± 0.4 cows observed with tail wagging in control vs. 3 ± 0.4 from the trap-deployed). The efficacy of the developed tapes lasted up to 1-week longevity, although 70% of m-cresol was released starting from the second day. The m-cresol impregnated adhesive tape provided an 80% reduction in cattle stress due to stable fly attack. This is the first report of a technology developed by integrating an attractant compound into an adhesive material on a plastic film with demonstrated effectiveness in trapping biting flies that attack livestock animals.

Polysomnographic characteristics and predictors of positional obstructive sleep apnea in Japanese elderly.

Sleep problems and obstructive sleep apnea (OSA) increase with age and disturb life in old age. Positional therapy is one option to treat OSA, but the differences in clinical pathophysiology between elderly and other age groups have not been fully investigated. We explored the pathophysiological features of sleep apnea, factors that are independently associated with positional OSA and the prevalence in elderly patients. We studied demographic and polysomnographic data of 85 elderly individuals with OSA (age ≥ 65 years) and 124 non-elderly patients with OSA (age, 20-64 years). The Amsterdam Positional OSA Classification (APOC) was used to evaluate positional OSA. Body mass index (BMI) and Epworth sleepiness scale were both significantly lower in the elderly group than in the non-elderly group, although apnea/hypopnea index (AHI) did not differ between groups. OSA severity affected total sleep time, sleep efficiency, and waking after sleep onset more in the elderly than in the non-elderly. AHI in the lateral position was significantly lower in elderly than in non-elderly, although AHI in the supine position was almost the same between two groups. The distribution of APOC 1 and 2 (lateral sleep effective) was significantly higher in the elderly than in the non-elderly. Relative factors such as BMI, rate of hypopnea, and lowest SpO2 associated with positional OSA in non-elderly groups did not differ significantly among APOC subgroups in elderly patients. Our findings are suggesting that characteristics of the positional OSA is different between elderly and younger-age OSA patients.

Patient characteristics affecting accurate detection of sleep apnea using a bed sheet-type portable monitor.

PURPOSE: Although performed inside a laboratory, attended polysomnography (PSG) has long been the gold standard for the diagnosis of sleep apnea. However, high costs and long wait times have led to the development of home-based portable monitoring devices. A bed sheet-shaped device called SD102 (Suzuken Co., Nagoya, Japan) has been developed, and its accuracy in evaluating sleep apnea is becoming evident. The purpose of this study was to confirm the accuracy of SD102 in evaluating sleep apnea and to investigate patient characteristics that may contribute to inaccurate test results in patients with suspected obstructive sleep apnea (OSA). METHODS: One hundred and eighty-nine patients simultaneously underwent PSG and portable monitoring by using a home sleep apnea testing (HSAT) device. A blinded, experienced technologist using the American Academy of Sleep Medicine criteria versions 2.1 and 2.3 scored the PSG data and HSAT device data, respectively. RESULTS: The respiratory event index (REI) by HSAT significantly correlated with the apnea-hypopnea index (AHI) by PSG (r = 0.974, p < 0.001). HSAT sensitivity, specificity, and positive and negative predictive values of 0.99, 0.83, 0.95, and 0.97, respectively. Body mass index and arousal index were significantly associated with the difference between REI from SD102 HSAT and AHI from PSG. CONCLUSIONS: This study demonstrates the good agreement between REI and AHI in patients with suspected OSA and suggests that understanding the limitations of different testing methods may help in the accurate detection of OSA.

Association between Uncoupling Protein 2 Gene Ala55val Polymorphism and Sudden Sensorineural Hearing Loss.

OBJECTIVES: The pathology of sudden sensorineural hearing loss, which is known as sudden deafness (SD), remains unknown. The purpose of this study was to investigate the association between mitochondrial uncoupling protein 2 (UCP2) polymorphism and SD risk. MATERIALS AND METHODS: We compared 83 patients suffering from SD and 2048 controls who participated in the Longitudinal Study of Aging at the National Institute for Longevity Sciences. Multiple logistic regression was used to calculate the odds ratios (ORs) for SD with a polymorphism of the UCP2 (rs660339) gene. RESULTS: Under the additive model of inheritance, UCP2 polymorphisms showed significant association with a SD risk. The OR was 1.468 (95% confidence interval, 1.056-2.040) with an adjustment for any past history, such as diabetes, dyslipidemia, or hypertension, and for age and sex. CONCLUSION: Our results imply that the UCP2 (rs660339) polymorphism has a significant association with the risk of developing SD.

Imaging of the endolymphatic space in patients with Ménière's disease.

OBJECTIVE: To examine endolymphatic hydrops (EH) using magnetic resonance imaging (MRI) in patients with definite Ménière's disease (MD) and those with nonotological diseases. METHODS: We studied 32 patients with unilateral MD, 10 patients with bilateral MD and 21 patients with control ears who had other benign diseases not associated with hearing or vestibular dysfunction. The mean age of the subjects was 54.0 years (range 27-74) in the MD group and 56.1 years (range 24-79) in the control group. Using MRI, the degree of EH was classified as none, mild and significant in the cochlea and vestibule separately. The ratio of the area of endolymphatic space to the vestibular fluid space was calculated for the vestibule. The duration of MD was defined as the months between the first attack of MD and the MRI study. RESULTS: EH was present in the cochlea of 45/52 affected ears of patients with MD (87%) and in 16/42 control ears (38%). Significant cochlear hydrops was present in 37/52 affected ears (71%) and in 4/42 control ears (10%). EH in the vestibule was present in 49/52 affected ears (94%) and in 3/42 control ears (7%). Significant vestibular hydrops was present in 40/52 affected ears (77%) and in none of the 42 control ears. There was no relationship between the degree of EH and its duration. Using a cut off value for the relative size of EH in the vestibule of 41.9%, the test had a sensitivity of 88.5% and a specificity of 100% to diagnose definite MD. CONCLUSION: Cochlear EH was occasionally observed in control ears on MRI, as in normal temporal bone specimens. The presence or absence and degree of vestibular EH were significantly different between ears with MD and control ears. EH in the vestibule might be a specific predictor of definite MD.

REM sleep without atonia in middle-aged and older psychiatric patients and Lewy body disease: a case series.

OBJECTIVE: Rapid eye movement (REM) sleep behavior disorder (RBD) is commonly associated with Lewy body disease, narcolepsy, or depression. In contrast, the relationship between REM sleep without atonia (RWA), which is a hallmark of RBD on polysomnography, and clinical characteristics remains unclear. The purpose of this study is to investigate the clinical features of psychiatric patients exhibiting RWA and its relevance to Lewy body disease. METHODS: Of 55 consecutive patients who underwent polysomnography at the psychiatric ward, 25 patients with sleep apnea syndrome were excluded, and 12 patients exhibiting RWA were identified. The clinical profiles were compared between the groups with and without RWA. RESULTS: The mean age and the frequency of neurocognitive disorders were significantly higher in 12 patients with RWA than in 18 without. Only five of the 12 patients exhibiting RWA had episodes of dream-enactment behavior, and fulfilled the clinical criteria for RBD. Two young patients were diagnosed with narcolepsy, while the other middle-aged and older patients fulfilled the clinical criteria for Parkinson's disease (n = 1), dementia with Lewy bodies (n = 4), idiopathic RBD (n = 2), and major depressive disorder (MDD) (n = 3). The patients with MDD exhibited constipation and/or olfactory dysfunction. Moreover, neuroimaging examinations in the patients with MDD revealed isolated occipital hypoperfusion in three patients and mild dopamine transporter deficit in one patient. CONCLUSIONS: Rapid eye movement sleep without atonia itself may be associated with specific clinical profiles, even when dream-enactment behavior is absent. Continued follow-up of the patients with MDD exhibiting RWA is warranted to determine if they represent the prodromal Parkinson's disease/dementia with Lewy bodies. Copyright © 2016 John Wiley & Sons, Ltd.

Prevalence of Sinusitis Detected by Magnetic Resonance Imaging in Subjects with Dementia or Alzheimer's Disease.

BACKGROUND: It has been reported that periodontitis is associated with Alzheimer's disease. However, the association between paranasal sinusitis and Alzheimer's disease has not been studied, although olfactory dysfunction frequently precedes the progress of dementia or Alzheimer's disease. METHODS: We studied 783 patients (283 men, 500 women; mean age 77.0 ± 7.9 years) who visited the Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, and 2139 control subjects who participated in a population-based study conducted by the National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA) in Japan. Sinusitis was evaluated using magnetic resonance imaging (MRI) according to the Lund-Mackay scoring system. A sinusitis score of ≥ 4 was classified as positive and a score of ≤ 3 was classified as negative. RESULTS: The prevalence of positive sinusitis was 6.3% in patients with a mini-mental state examination (MMSE) score of < 24 (n = 507), and 5.7% in patients with Alzheimer's disease (n = 280). The rate of positive sinusitis was7.2% in the control group. The prevalence of sinusitis was not significantly different between normal controls and patients with dementia or Alzheimer's disease after adjustments for age and sex. The rate of positive sinusitis was higher in male than in female subjects in both groups. CONCLUSION: The prevalence of sinusitis in patients with Alzheimer's disease or dementia was not higher than in the general population.

Changes in endolymphatic hydrops in patients with Ménière's disease treated conservatively for more than 1 year.

CONCLUSION: This study revealed that endolymphatic hydrops (EH) reduced in some cases with Ménière's disease (MD) treated conservatively. It appears that the EH reduction was associated with improvement of the clinical symptoms. OBJECTIVES: The relationship between the degree of EH and clinical symptoms is not clear at present. The purpose of the present study was to investigate the time course of the relationship in patients with MD treated conservatively. PATIENTS: Twelve patients with MD treated conservatively for more than 1 year in a university hospital. METHODS: Twenty ears of 12 patients with MD treated conservatively were evaluated. The presence or absence of vertigo, tinnitus and ear fullness was confirmed when magnetic resonance imaging (MRI) was performed. Using a 3 T MRI scanner, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI was performed 2 or 3 times 24 hours after intra-tympanic gadolinium injection or 4 hours after intravenous gadolinium injection. RESULTS: In the three ears in which the symptoms alleviated, EH was reduced in two ears, but EH was reduced in only one of 17 ears in which the symptoms did not alleviate. The Fisher exact test revealed that EH reduction occurred more frequently in ears with alleviation of the symptoms (p < 0.05).

Obstructive sleep apnea syndrome in a pubescent boy of short stature was improved with an orthodontic mandibular advancement oral appliance: a case report.

ABSTRACT: We report a 16-year-old pubescent pediatric patient with obstructive sleep apnea syndrome (OSAS) and short stature whose apnea hypopnea index (AHI) was significantly reduced following the use of an orthodontic oral appliance that advances the mandible ventrally. The mandible was advanced 64% of the maximal mandibular protrusive position with use of the appliance over a 3-year period. The patient's AHI without the appliance in place decreased from 101.6/h at baseline to 11/h after treatment. Moreover, the patient's height increased 14 cm during treatment, resulting in height close to the average height for his age. Cephalometric analysis revealed an improvement in his retrognathic mandible and proclination of the upper front teeth. In conclusion, an orthodontic mandibular advancement oral appliance played an important role not only in improving the patient's OSAS but also in normalizing his physical growth during puberty.

Endolymphatic space size in patients with vestibular migraine and Ménière's disease.

Ménière's disease (MD) is characterized by episodic vertigo, fluctuating hearing loss and tinnitus. Vestibular migraine (VM) is a relatively new disorder that is characterized by episodic vertigo or dizziness, coexisting migraine and absence of hearing loss. It is occasionally difficult to distinguish between VM and vestibular MD with headache. Because endolymphatic hydrops (EH) is a characteristic sign of MD, we attempted to evaluate endolymphatic space size in both diseases. Endolymphatic space size in the vestibule and the cochlea was evaluated in seven patients with VM and in seven age- and sex-matched patients with vestibular MD. For visualization of the endolymphatic space, 3T magnetic resonance imaging was taken 4 h after intravenous injection of gadolinium contrast agents using three-dimensional fluid-attenuated inversion recovery and HYbriD of reversed image of positive endolymph signal and native image of positive perilymph signal techniques. In the vestibule of VM patients, EH was not observed, with the exception of two patients with unilateral or bilateral EH. In contrast, in the vestibule of patients with vestibular MD, all patients had significant EH, bilaterally or unilaterally. These results indicate that endolymphatic space size is significantly different between patients with VM and vestibular MD.

Numerical assessment of cholesteatoma by signal intensity on non-EP-DWI and ADC maps.

OBJECTIVE: To establish a methodology for magnetic resonance imaging (MRI) assessment in the diagnosis of cholesteatoma using signal intensity on BLADE diffusion-weighted MRI (BLADE-DWI) and apparent diffusion coefficient (ADC) mapping. STUDY DESIGN: Retrospective case series. SETTING: University hospital. PATIENTS: Participants comprised 29 patients who underwent middle ear surgery and in whom preoperative differential diagnosis between cholesteatoma and other middle ear diseases was difficult using local and computed tomographic findings and required BLADE-DWI. INTERVENTION: Signal intensity ratio (SIR) between the affected region of the middle ear and the pons measured by BLADE-DWI and on ADC maps was evaluated numerically. SIR in an area located near the target lesion in each case was used as a control. Values were compared between both cases in which cholesteatoma was histopathologically confirmed (cholesteatoma group) and cases in which cholesteatoma was excluded on histopathologic examination (noncholesteatoma group). MAIN OUTCOME MEASURES: Imaging and histopathologic findings. RESULTS: SIR on BLADE-DWI was significantly higher in the cholesteatoma group than in the noncholesteatoma group, although both groups showed significantly higher SIR in the target lesion than in the control area. Moreover, SIR on ADC maps was significantly lower in the cholesteatoma group than in the noncholesteatoma group. The clear cutoff value of SIR on ADC maps was 1.5. CONCLUSION: The combination of BLADE-DWI and ADC mapping offers a useful imaging tool for accurate detection of middle ear cholesteatoma. Use of SIR can numerically differentiate between cholesteatoma and noncholesteatoma.

Antimicrobial prophylaxis in tonsillectomy: the efficacy of preoperative single-dose oral administration of azithromycin in preventing surgical site infection.

CONCLUSION: The results indicate that oral administration of azithromycin (AZM) is equivalent to intravenous administration of cefazolin (CEZ) for preventing surgical site infection (SSI) in patients undergoing tonsillectomy, and should be used as cost-effective antimicrobial prophylaxis. OBJECTIVE: Staphylococcus aureus, Streptococcus spp., and pharyngeal anaerobes have been described as major pathogens causing SSI in transpharyngeal operations such as tonsillectomy. The purpose of this study was to explore whether administration of AZM, an oral antimicrobial agent, might be equivalent to intravenous administration of a first-generation cefem antimicrobial agent for preventing SSI in patients undergoing tonsillectomy. METHODS: Patients undergoing tonsillectomy were divided into an AZM-treated group and a CEZ-treated group, for intergroup comparison of responses. AZM was administered once orally, 2 days before the operation, whereas patients in the CEZ-treated group received CEZ intravenously 30 min before the operation, 4 h postoperatively, and then twice daily for 3 consecutive days beginning the day after the operation. RESULTS: There were no significant intergroup differences in mean duration of hospitalization after the operation, incidence of postoperative hemorrhage, postoperative analgesic effect, or hematologic/blood biochemical findings. The incidence of postoperative fever was significantly lower in the AZM-treated group. Diarrhea occurred as an adverse drug reaction in the AZM-treated group, but no clinically significant adverse reactions were noted.

Evaluation of vascular activity in otosclerosis by laser Doppler flowmetry: comparison with computed tomographic densitometry.

OBJECTIVE: To evaluate vascular activity in ears with otosclerosis by intraoperative measurement of blood flow using laser Doppler flowmetry and to compare the data with densitometry on computed tomography (CT). DESIGN: Retrospective case series. SETTING: University hospital. PATIENTS: Thirty-nine ears from 33 patients who underwent surgery for otosclerosis. INTERVENTION: The subjects were divided into fenestral (29 ears) and retrofenestral (10 ears) groups based on CT findings. Ratios of bone density in the area anterior to the oval window (AOW) or the promontory (PT) near the round window niche to that of the basis labyrinthine otic capsule were calculated on CT images. Measurements of blood flow were performed with a laser Doppler flowmeter at the 2 corresponding areas evaluated by CT. MAIN OUTCOME MEASURES: Imaging and blood flow values. RESULTS: In both groups, relatively young subjects with high blood flow values in the AOW or PT had rather low ratios of bone density in the corresponding areas. In contrast, old subjects with low ratios of bone density showed low blood flow values in the same areas. In the retrofenestral group, subjects with high blood flow values in the PT showed low blood flow values in the AOW, but their ratios of bone density were similarly low in both areas. CONCLUSION: Blood flow varied and did not correlate with CT densitometry. Measurement of blood flow by laser Doppler flowmetry could yield useful information to evaluate the progress of vascular activity.

Endolymphatic hydrops revealed by magnetic resonance imaging in patients with acute low-tone sensorineural hearing loss.

OBJECTIVE: Acute low-tone sensorineural hearing loss (ALHL) has been reported to be associated with endolymphatic hydrops (EHs). However, evaluation of the size of the endolymphatic space has not been reported. We attempted to visualize EH in ALHL using magnetic resonance imaging (MRI). STUDY DESIGN: Prospective diagnostic study. SETTING: University hospital. METHODS: We evaluated 25 ears of 25 unilateral ALHL patients. Three-tesla MRI was obtained 24 hours after intratympanic injection of gadolinium (Gd) (n = 5) or 4 hours after intravenous injection of Gd (n = 20). A radiologist blinded to the patients' clinical data classified the degree of EH in the vestibule and cochlea into 3 groups: none, mild, and significant. RESULTS: On the affected sides, cochlear EH was recognized in 23 ears (92%) and was classified as significant EH (n = 15) or mild EH (n = 8); vestibular EH was detected in 22 ears (88%), classified as significant EH (n = 16) or mild EH (n = 6). Cochlear EH was more frequently observed in the affected ear than in the contralateral ear (90% versus 40%, p < 0.05). CONCLUSION: In ALHL, EH was observed not only in the cochlea but also in the vestibule as in Ménière's disease.

Endothelin-1 gene polymorphism in sudden sensorineural hearing loss.

OBJECTIVES/HYPOTHESIS: Endothelin-1 is a potent vasoconstrictor peptide that is widely distributed throughout the mammalian body including the spiral modiolar artery, vestibule, and cochlea. This study aimed to investigate the association between the Lys198Asn (G/T) polymorphism (rs5370) of the endothelin-1 gene and sudden sensorineural hearing loss (SSNHL). STUDY DESIGN: Case-control study. METHODS: Seventy-two SSNHL patients (mean age, 58.3 ± 14.0 years) were compared with 2,159 controls included in a community-based study of aging. Multiple logistic regression was used to obtain odds ratios (ORs) for SSNHL. In subgroup analysis, patients with SSNHL who visited to the hospital within the first month of onset were selected to assess audiometric features according to genotype. Pure-tone averages at 250, 500, 1,000, 2,000, and 4,000 Hz were calculated in the affected ear. RESULTS: Under the recessive genetic model, after adjustment for age, sex, histories of hypertension, dyslipidemia and diabetes, the crude and adjusted ORs for SSNHL risk were 2.209 (95% confidence interval [CI]: 1.140-4.281) and 2.173 (95% CI: 1.086-4.348), respectively. No significant ORs were observed under the additive and dominant models. The severity of SSNHL differed significantly between genotypes. The mean pure-tone averages at the initial visit were 78.6, 66.4, and 57.8 dB for the GG, GT, and TT genotypes, respectively (P = .034). CONCLUSIONS: Our study indicates that the recessive genotype was significantly associated with increased SSNHL risk; however, the severity was lower in these individuals than it was in those with the wild-type genotype. Endothelin-1 may be implicated in SSNHL.

Comparison of oxygen desaturation patterns in children and adults with sleep-disordered breathing.

PURPOSE: Although the number of apnea-hypopnea episodes per hour apnea-hypopnea index (AHI) is typically used to evaluate sleep-disordered breathing (SDB) in adults, it does not provide an accurate characterization of SDB in children. We investigated differences in SDB patterns in children and adults to evaluate SDB severity in children. MATERIALS AND METHODS: Fifteen adults (mean age, 45.3 ± 8.4 years) and 15 children (mean age, 6.7 ± 3.9 years) with adenotonsillar hypertrophy underwent standard polysomnography. The change of oxygen saturation (ΔSpO2) was defined as the difference between baseline SpO2 during stable nighttime breathing and the lowest SpO2 accompanied by an apnea-hypopnea event. The number of apnea-hypopnea episodes was determined using two different criteria to define an episode (criterion 1: cessation of airflow for at least 10s; criterion 2: cessation of airflow for at least two consecutive breaths). RESULTS: Mean ΔSpO2 accompanied by obstructive apneas lasting ≤10 s was significantly greater in children than in adults, although there was no significant difference in the duration of apnea-hypopnea episodes. The slope of the regression line between ΔSpO2 and apnea-hypopnea duration in children was greater than in adults (P<0.005). AHI in children was higher when calculated using criterion 2 compared to criterion 1 (10.9 ± 9.4 vs. 6.5 ± 4.9/h, P=0.003). CONCLUSIONS: ΔSpO2 is a good indicator of SDB severity in children, and should therefore be considered in the diagnosis and treatment of pediatric SDB along with AHI.

Association between polymorphisms in genes encoding methylenetetrahydrofolate reductase and the risk of Ménière's disease.

Folate metabolism is essential for cellular functioning. Despite extensive research on the roles of folate-metabolism-related gene polymorphisms in the pathophysiology of many diseases, such as cardiovascular disease, cancers, and sudden sensorineural hearing loss, little is known about their association with Ménière's disease (MD). The aim of this study was to investigate the effect of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms (C677T and A1298C) on the risk of MD in a Japanese population. We examined the C677T and A1298C (rs1801133 and rs1801131) polymorphisms in the MTHFR gene and compared them between 1946 adults (986 men and 960 women) participating in the National Institute for Longevity Sciences Longitudinal Study of Aging and 86 cases of MD. A multiple logistic regression was performed to obtain odds ratios (ORs) for the risk of MD regarding the MTHFR polymorphisms before (model 1) and after (model 2) adjustment for age and sex factors. The OR of MTHFR C677T for the risk of MD was 0.669 (95% confidence interval [CI], 0.479-0.934) in model 1 and 0.680 (95% CI, 0.484-0.954) in model 2. In contrast, the OR of MTHFR A1298C for the risk of MD was 1.503 (95% CI, 1.064-2.123) in model 1 and 1.505 (95% CI, 1.045-2.167) in model 2. Our results imply that the MTHFR C677T and A1298C polymorphisms are associated with the risk of MD.

Endolymphatic hydrops in patients with tinnitus as the major symptom.

Tinnitus is one of the symptoms of Meniere's disease. The relationship between a clinical presentation of subjective tinnitus or ear fullness and endolymphatic hydrops (EH) has not yet been explored. We studied 15 patients with symptoms of tinnitus as their major complaint, with or without hearing loss, who were evaluated using magnetic resonance imaging (MRI). The mean age of the subjects was 59 years (range 35-79 years). Nine were women and six were men. Patients were divided into two groups based on whether they had fluctuating or stable tinnitus. These groups were subdivided in the presence or absence of accompanying sensation of ear fullness. MRI was performed 4 h after intravenous gadolinium administration. Overall, 30 ears were evaluated. EH in the cochlea was present in 14 of 25 symptomatic ears (56 %) in patients with tinnitus as the major complaint. Significant hydrops was present in 7 of 14 ears and mild hydrops in the other ears. Patients with fluctuating tinnitus had EH more frequently than patients with stable tinnitus. Furthermore, the presence of ear fullness also correlated with the presence of EH in the cochlea. However, there was no significant relationship between EH in the cochlea and age, sex, duration of tinnitus, hearing level or the configuration of the audiogram. Our study revealed that patients who had tinnitus as their major symptom often had EH. Using MRI to identify this covert early EH in patients who have tinnitus as their major symptom may broaden the treatment options for tinnitus.

Magnetic resonance imaging of the inner ear after both intratympanic and intravenous gadolinium injections.

CONCLUSION: Using magnetic resonance imaging (MRI), endolymphatic hydrops could be visualized on both sides after intratympanic (IT) injection of gadolinium contrast agents (Gd) in one symptomatic ear and subsequent intravenous (IV) Gd injection. The MRI revealed a difference of intracochlear Gd distribution between the IT injection side and the contralateral IV side. OBJECTIVES: Although the IT method allows greater enhancement of the perilymph, many patients feel reluctance in receiving the IT injection in asymptomatic ears. We attempted to evaluate endolymphatic space size on both sides without the IT injection in asymptomatic ears. METHODS: In 10 patients with Meniere's disease, MRI was performed 24 h after the IT Gd injection in one symptomatic ear and 4 h after the IV Gd injection. The signal intensity of Gd in the basal and apical turns of the cochlea was evaluated. RESULTS: The signal intensity in the scala tympani of the basal turn of the cochlea was 1.70 ± 0.60 on the IT + IV side and 0.42 ± 0.10 on the contralateral (IV) side. Gd was distributed uniformly in the scala tympani in the cochlea on the IV side, whereas it was strongly localized in the basal turn on the IT + IV side.

Polymorphisms in genes encoding aquaporins 4 and 5 and estrogen receptor α in patients with Ménière's disease and sudden sensorineural hearing loss.

AIMS: The etiologies of Ménière's disease and idiopathic sudden sensorineural hearing loss (SSNHL) remain unclear. The homeostasis of the water and blood circulation in the inner ear is essential for maintaining its hearing and equilibrium functions, and aquaporins and estrogen are involved in the fluid or ion balance in the inner ear. We investigated the associations between genetic polymorphisms in aquaporin 4 (AQP4, rs2075575), aquaporin 5 (AQP5, rs3736309), and estrogen receptor α (ERα1, rs2234693; ERα2, rs9340799) and susceptibility to Ménière's disease or SSNHL. MAIN METHODS: We compared 86 patients affected by Ménière's disease, 85 patients affected by SSNHL, and 2136 adults who were participants in a comprehensive longitudinal study of aging. KEY FINDINGS: With the AQP5 polymorphism, the odds ratio for Ménière's disease was 0.676 (95% confidence interval: 0.477-0.957) after adjustment for age and sex, when an additive genetic model was used. The AQP5 polymorphism entailed no significant risk of SSNHL and the polymorphisms of AQP4, ERα1, and ERα2 entailed no significant risk of Ménière's disease or SSNHL in the additive genetic model, regardless of adjustments for age and sex. SIGNIFICANCE: Our study suggests that the variant G allele of AQP5 polymorphism rs3736309 reduces the risk of Ménière's disease.