• BMB Reports
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• v.32 no.1
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• pp.25-27
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• 1999

Otitis media with effusion (OME) is an inflammatory disease of the middle ear cleft. Oxygen free radicals have been implicated in a variety of inflammatory disorders. Oxygen free radicals may also be involved in the pathogenesis of OME. To evaluate the involvement of oxygen free radicals in the pathogenesis of OME, the level of malondialdehyde, which gives an index of lipid peroxidation by oxygen free radicals, was measured by the reaction with thiobarbituric acid. Malondialdehyde level in the middle ear fluid from the OME group was higher than that in the normal control group. Malondialdehyde level in the middle ear fluid from a mucoid subgroup was higher than that in the serous subgroup. Malondialdehyde levels in the middle ear fluid from the serous subgroup was significantly correlated with symptom duration. The Pearson correlation coefficient between malondialdehyde levels in the middle ear fluid from the serous subgroup and symptom duration was 0.842 (P<0.05). These results indicate that lipid peroxidation by oxygen free radicals may be involved in the pathogenesis of human OME.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.70-75
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• 2018

Background: Otitis media with effusion (OME) is defined as middle ear effusion without acute signs of infection. OME usually resolves spontaneously; however, persistent OME may require the insertion of a ventilation tube. This study investigated risk factors for persistent OME in children who undergo ventilation tube insertion. Methods: Children who were admitted to undergo ventilation tube insertion at Jeju National University Hospital between August 2015 and July 2016 were enrolled as the case group. Healthy children without persistent OME from August 2016 to July 2017 were enrolled as the control group. Baseline characteristics and predisposing factor data were collected using an interview questionnaire. Middle ear fluids were collected from the case group. Results: A total of 31 patients underwent ventilation tube insertion. The mean age of the case group was 4.53 years, with a male-to-female ratio of 21:10. Twenty-nine (93.5%) children attended a daycare center, and 21 (67.7%) had experience with bottle feeding. Fifteen (48.4%) children in the case group and 3 (9.7%) in the control group first attended a daycare center at <1 year of age (odds ratio=9.96; 95% confidence interval=2.44-39.70; p=0.001). No bacteria were found in middle ear fluid collected from the 31 operated children. Nasopharyngeal bacterial colonization was found in 13 (41.9%) and 17 (54.8%) children in the case and control groups, respectively. Conclusion: Earlier attendance at a daycare center was the only predisposing factor for ventilation tube insertion in our study. The aseptic nature of middle ear fluids found in children with OME highlights the efficacy of antimicrobial use.

• Korean Journal of Microbiology
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• v.39 no.1
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• pp.36-39
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• 2003

The rapid and reliable 16S rDNA multiplex polymerase chain reaction (PCR) assay was established to characterize bacterial etiologies of middle ear effusion. These etiologies included Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumonia, which were detected in middle-ear effusion (MEE) samples taken from patient with otitis media. A total of 39 MEE samples were aspirated from 26 patients. DNA was extracted from MEE samples, and PCR was done with DNA extracts by using the common primers, which is localized at C4 region in the 16S rDNA gene of all bacterial species, and species-specific primers: (i) Haemophilus-specific primer, (ii) Moraxella- specific primer, and (iii) Streptococcus-specific primer. Among 39 samples tested, 24 (61.5%) were positive for H. influenzae, 10 (25.6%) were positive for M. catarrhalis, 3(7.7%) were positive for S. pneumonia, and 11 (28%) were negative for 165 rDNA multiplex PCR reaction. Nine samples (28.6%) exhibited a mixed infection and were positive for both H. infuenzae and M. catarrhalis. We suggested that 16S rDNA multiplex PCR is a useful method to identify rapidly for rapid identification of the pathogenic bacteria and characterization of bacterial etiologies of middle ear effusion.

• The Journal of Pediatrics of Korean Medicine
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• v.16 no.2
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• pp.39-49
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• 2002

The author measured IL-8 and $TGF-{\beta}1$ levels of 84 ears - 48 ears of them had treated by antibiotics, 36 of them by Kamihyunggyeyungyotang(KHY) - of pediatric recurrent otitis media with effusion using ELISA assay, and compared them. The results were obtained as follows. 1. The level of IL-8 in KHY group was significantly lower than that in antibiotics group(p<0.05). 2. The level of $TGF-{\beta}1$ in KHY group was lower than that in antibiotics group. According to above results, KHY is considered to be used for treating recurrent otitis media with effusion by controlling the production of interleukin-8 and transforming $growthfactor-{\beta}1$.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.15.1-15
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• 1982

Clinical findings for 95 patients (159 ears) of MEE (middle ear effusion) treated at Wallace Memorial Baptist Hospital (Busan) from July 1979 to August 1981 were observed. A group who was treated with myringotomy and ventilation tube isertion was compared with another group of children treated with adenotonsillectomy at the same time. The following are the results: 1) The sex distribution showed 48 male and 47 female, and the age distribution was most common in the ages from six to ten (34 cases, 35%). 2) MEE of children treated with adenotonsillectomy in the same duration was 18 cases (14%), and it was 19% of all MEE patients. 3) Bilateral effusion (67%) was as twice as unilateral cases (33%). In children, bilateral effusion (42 cases, 88%) was predominant, and MEE in adenotonsillectomized children was bilateral in all cases. 4) The nature of middle ear fluid was 49% serous exudate, 33% mucoid exudate, 5% purulent and 3% bloody fluid. Serous exudate was 59% in adult group, but serous (41%) and mucoid exudate (43%) was similar incidence in children. 5) In the preoperative tympanogram, there were 6% with type A, 91% with type B, and 3% with type C. The incidence of abnormal tympanogram (type B or C) was same in MEE patients of adenotonsillectomized children (95%) and the other children group (95%), and it was 93% in adult group. 6) Treatment by myringotomy and ventilation tube insertion resulted in postoperative improvement in air conduction hearing acuity especially in adenotonsillectomized children.

• The Journal of Korean Medicine
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• v.30 no.3
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• pp.51-60
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• 2009

Objectives : It has been known that immune reaction plays an important role in the pathogenesis of otitis media (OM). We investigated the change of middle ear mucosal inflammation induced by lipopolysaccharide (LPS) following administration of Taglisodog-eum (TSE) in experimental animals. Materials and Methods : Otitis media was induced by injecting 1 mg/kg of Pseudomonas aeruginosa LPS transtympanically in 60 rats. These rats were divided into two groups, the LPS group (n=30, remained naive after OM elicitation) and the TSE group (n=30, treated with TSE after OM elicitation) and 6 additional rats were kept as a normal control group (n=6, remained naive until tissue collection). The rats were killed at the 1st, 3rd, and 7th days after challenge. The temporal bones in each group were harvested and examined histopathologically by hematoxyline-eosin stain. Middle ear mucosa were taken at the 1st, 3rd, and 7th days after challenge. The levels of spicing variants of TNF-${\alpha}$ transcription were evaluated by Realtime-PCR. Results : TSE suppressed LPS-induced TNF-${\alpha}$ mRNA expression and thickness of the submucosal layer and infiltration of inflammatory cells in rat middle ear epithelium. Conclusion : The results suggest that TSE may be effective in decreasing inflammation with particular application to mucosal metaplasia in OM.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.1
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• pp.131-153
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• 2001

The author measured IgG1, IgG2, IgG3 and IgG4 levels of 22 ears-11 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang-of pediatric recurrent otitis media with effusion using ELISA assay, and compared them. The results were obtained as follows. 1. The level of IgG1 in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P=0.002). 2. The level of IgG2 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.178). 3. The level of IgG3 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.215). 4. The level of IgG4 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.198). According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by controlling the production of immunoglobulins.

• Applied Microscopy
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• v.12 no.1
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• pp.1-10
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• 1982

Serous otitis media is closely related with auditory tube function, but its etiology and pathogenesis are not clearly defined yet. So we tried to prove the theory of hydrops ex vacuo via the experimental study with cats by means of obstructing the pharyngeal orfice of the auditory tube and observe the serial changes in tympanic mucosa through light and electron microscopy. The results are as follows; 1. We confirmed the production of serous otitis media with auditory tube obstruction and have a new understanding of auditory tube function in middle ear aeration. 2. The effusion in serous otitis media was produced from the next day of experiment and increased till the fourteenth day, but decreased after the spontaneous perforation of ear drum. 3. Through the light microscopy, we observed the increasement of the sercretory cells including goblet cells, epithelial hyperplasia, capillary proliferation and invasion of inflammatory cells. 4. Through the elctron microscopy, we observed the protrusion of secretory cells, blobs in cilia, loss of cilia, increasement of vesicles, vacuoles and dense bodies in ciliated cells and Invasion of inflammatory cells. With above results, we concluded that aeration through auditory tube is the most important factor in serous otitis media and presumed the effusion was secreted by secretory cells.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.13.2-14
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• 1982

Otitis media with effusion, described first by Politzer (1867), is closely related with the function of auditory tube, but its etiology and pathogenesis are not clearly defined yet. There are many theories about its pathogenesis including hydrops ex vacuo theory which was most reliable nowadays. In this paper, using cats in experimental animals, hydrops ex vacuo theory was proved and cytological study of the effusion and light microscopic observation of the middle ear mucosa in otitis media with effusion were done. The results were as follows: 1) The effusion was found in all experimental groups after eighteen hours of the auditory tube obstruction. 2) In the cytological study of effusion by smear technic, Polymorpholeukocytes were dominant in earlier days but monoculear cells were soon increased and no eosinophils were found. 3) In the culture of the effusion, no bacteria was cultured. 4) By opeating microscope, hypertrophy of the middle ear mucosa observed especially in the fourteen days after auditory tube obstruction and effusion was most remarkable in the fourteen days, also. 5) By light microscopy, there were epithelial hyperplasia, proliferation of goblet cells, capillaries and infiltration of inflammatory cells which showed same distribution as smear technic.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.640-648
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• 2020

Objective : This study aimed to assess the relationship between increased intracranial pressure (ICP) and mastoid effusions (ME). Methods : Between January 2015 and October 2018, patients who underwent intracranial surgery and had ICP monitoring catheters placed were enrolled. ICP was recorded hourly for at least 3 days. ME was determined by the emergence of opacification in mastoid air cells on follow-up brain imaging. C-reactive protein (CRP) levels, presence of endotracheal tube (ETT) and nasogastric tube (NGT), duration of intensive care unit (ICU) stay, duration of mechanical ventilator application, diagnosis, surgical modalities, and presence of sinusitis were recorded. Each factor's effect on the occurrence of ME was analyzed by binary logistic regression analyses. To analyze the independent effects of ICP as a predictor of ME a multivariable logistic regression analysis was performed. Results : Total of 61 (53%) out of 115 patients had ME. Among the patients who had unilateral brain lesions, 94% of subject (43/50) revealed the ipsilateral development of ME. ME developed at a mean of 11.1±6.2 days. The variables including mean ICP, peak ICP, age, trauma, CRP, ICU stays, application of mechanical ventilators and presence of ETT and NGT showed statistically significant difference between ME groups and non-ME groups in univariate analysis. Sex and the occurrence of sinusitis did not differ between two groups. Adding the ICP variables significantly improved the prediction of ME in multivariable logistic regression analysis. Conclusion : While multiple factors affect ME, this study demonstrates that ICP and ME are probably related. Further studies are needed to determine the mechanistic relationship between ICP and middle ear pressure.