• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.658-662
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• 2018

Background and Objectives The early assessment of treatment is not done for benign paroxysmal positional vertigo (BPPV) since the well-known phenomenon of fatigability after a repeated positional test can mimic successful treatment. The aim of this study is to evaluate the clinical implication of 'fatigability' after Epley maneuver and to identify the therapeutic efficacy of Epley maneuver in posterior canal BPPV (PC-BPPV). Subjects and Method This study was prospectively conducted by two dizziness clinics on 51 consecutive patients diagnosed with PC-BPPV. All patients included in the study received Epley maneuver treatment. The therapeutic results were reassessed immediately after a single trial of Epley maneuver. After 30 minutes, results were reassessed repeatedly to confirm the fatigability of diagnostic procedure immediately after treatment. If the treatment was not successful after 30 minutes, Epley maneuver was repeatedly performed until complete resolution. Results Immediately after the first maneuver, 45 of 51 (88.2%) patients had neither vertigo nor nystagmus during the positional test. All patients demonstrated complete resolution after receiving one to three Epley maneuvers on the day of diagnosis. 'Fatigability (false negative result)' was confirmed for only one case (1 of 6 patients, 16.7%), in which nystagmus was observed after 30 minutes but not identified immediately after the first Epley maneuver. Conclusion The therapeutic efficacy of Epley maneuver is very high in PC-BPPV. Considering the possibility of fatigability when reassessment is performed immediately after therapeutic maneuver, clinicians should avoid assessing the outcome immediately after treatment in patients with PC-BPPV.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.663-668
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• 2018

Background and Objectives The main objectives of this study were to determine the clinical usefulness of the program-assisted and real ear measurement (REM)-assisted fitting of hearing aids. Subjects and Method Fifteen participants with moderate to moderately severe hearing loss were enrolled in this study. Objective and subjective fitting results were assessed to compare the benefits between the program-assisted fitting (using a software fitting program) and the REM-assisted fitting. Real ear insertion gain (REIG), sound-field audiometry using warble tone, and Korean Hearing in Noise Test (K-HINT) were performed as objective tests. Sound quality rating was performed as a subjective test. Results In the program fitting, 48.89% of fitting points failed to come within ${\pm}10dB$ of the REIG target. In the REM fitting, however, the percentage of failure significantly decreased to 23.33% (p=0.013). In K-HINT test, the reception threshold for speech in quiet situation significantly decreased from 50.1 dB HL with the program fitting to 44.7 dB HL after the REM fitting (p<0.001). In front noise condition, signal-to-noise ratio improved from 4.53 dB to 3.50 dB with the REM fitting without statistical significance (p=0.099). In the sound quality rating, the REM fitting ($4.27{\pm}0.56$) showed a significantly better sound quality ratings than the program fitting ($3.69{\pm}0.74$) (p=0.017). Conclusion The REM fitting showed better results in both subjective and objective measurements than the program fitting.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.588-592
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• 2018

Background and Objectives The incidence of facial bone fracture is increasing. The zygomatic bone, due to its anatomical prominence, is the second most common site of all facial bone fractures. In this study, we present the clinical experiences of zygomatic arch fracture in a tertiary hospital and introduce the Gillies approach for reduction and its outcome results. Subjects and Method We collected data from retrospective chart reviews of patients who underwent surgeries from 2010 to 2017 for zygomatic arch fractures at Chungbuk National University Hospital. Data were analyzed according to age, gender, cause of trauma, location of trauma, and clinical symptoms including trismus. All surgery was performed under general anesthesia and via the use of Gillies approach. The result of surgery was evaluated by postoperative facial computed tomography. Results Sixteen patients underwent surgery for zygomatic arch fracture. The patients had the average age of 41.3 years, a male predominance of 15:1 and physical assault as the most common cause of trauma. The time lag between injury and surgical reduction was 5.5 days. The surgical outcomes were assessed 'good' in 14 cases and 'moderate' in one case. Patients who had trismus preoperatively were resolved of it in all cases after operation. Postoperative complications were absent. Conclusion The Gillies approach proved to be a relatively easy, safe, and reliable method, and its surgical outcomes was satisfactory in our experiences.

• Journal of Acupuncture Research
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• v.36 no.3
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• pp.166-171
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• 2019

This study aimed to report the effect of Korean medical treatment including miniscalpel acupuncture on 2 patients who underwen tsurgery for rotator cuff tear. They were treated for almost 4 weeks at the Department of Acupuncture and Moxibustion, Dong-Eui University Korean Medicine Hospital. Visual analog scale (VAS), and range of movement (ROM) were used to evaluate treatment effects. In both patients, shoulder pain and restriction of shoulder joint movement improved after miniscalpel acupuncture treatment. In Case 1, shoulder pain decreased from a VAS score 8 to a VAS score 3, and ROM of the shoulder improved from flexion $100^{\circ}$ to $160^{\circ}$, extension $10^{\circ}$ to $30^{\circ}$, abduction $90^{\circ}$ to 1$30^{\circ}$, adduction $10^{\circ}$ to $40^{\circ}$, internal rotation $10^{\circ}$ to $50^{\circ}$, and external rotation $10^{\circ}$ to $50^{\circ}$. In Case 2, shoulder pain, which was rated a VAS score 8 at first-visit, disappeared, and ROM of the shoulder recovered to normal range. These results suggest miniscalpel acupuncture may contribute to the recovery process after rotator cuff tear surgery.

• Journal of Korean Neurosurgical Society
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• v.62 no.6
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• pp.626-634
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• 2019

Objective : Nerve growth factor (NGF) is a member of the neurotrophic factor family and plays a vital role in the physiological processes of organisms, especially in the nervous system. Many recent studies have reported that NGF is also involved in the regulation of tumourigenesis by either promoting or suppressing tumor growth, which depends on the location and type of tumor. However, little is known regarding the effect of NGF on interspinal schwannoma (IS). In the present study, we aimed to explored whether mouse nerve growth factor (mNGF), which is widely used in the clinic, can influence the growth of interspinal schwannoma cells (ISCs) isolated from IS in vitro. Methods : ISCs were isolated, cultured and identified by S-100 with immunofluorescence analysis. S-100-positive cells were divided into five groups, and separately cultured with various concentrations of mNGF (0 [phosphate buffered saline, PBS], 40, 80, 160, and 320 ng/mL) for 24 hours. Western blot and quantantive real time polymerase chain reaction (PCR) were applied to detect tyrosine kinase A (TrkA) receptor and p75 neurotrophin receptor ($p75^{NTR}$) in each group. Crystal violet staining was selected to assess the effect of mNGF (160 ng/mL) on ISCs growth. Results : ISCs growth was enhanced by mNGF in a dose-dependent manner. The result of crystal violet staining revealed that it was significantly strengthened the cells growth kinetics when cultured with 160 ng/mL mNGF compared to PBS group. Western blot and quantantive real time PCR discovered that TrkA receptor and mRNA expression were both up-regualated under the condition of mNGF, expecially in 160 ng/mL, while the exoression of $p75^{NTR}$ demonstrated no difference among groups. Conclusion : From these data, we conclude that exogenous mNGF can facilitate ISC growth by activating both TrkA receptor and $p75^{NTR}$. In addition, patients who are suffering from IS should not be administered mNGF in the clinic.

• The Journal of Pediatrics of Korean Medicine
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• v.33 no.3
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• pp.15-29
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• 2019

Objectives The purpose of this study is to investigate the clinical studies on the effect of herbal medicine in type 1 diabetes in children and to seek better approach of herbal medicine to treat type 1 diabetes in children. Methods This study researched randomized controlled trials through various databases in the world about herbal medicine treatments in type 1 diabetes in children. Results 10 out of 337 studies were selected and analyzed. All studies were conducted in China. All studies were using herbal medicines, as an adjunctive treatment to the main regimen. As a result, the integrated Chinese medicine and western medicine lowered FPG by -1.56 mmol/L and 2hPG by -1.94 mmol/L on average, respectively. The HbA1c also decreased by -1.11% in the treatment group compared to the control group. Total efficacy of the treatment was 1.21 times more effective in the treatment group than in the control group. Conclusions Based on the results of the studies, it seems that the herbal medicine for the treatment of type 1 diabetes in children will be effective as a combination with conventional medicines. Further research is needed to prove the findings of this observatoional studies.

• The Journal of Internal Korean Medicine
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• v.40 no.2
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• pp.192-200
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• 2019

Introduction: The aim of this study is to report the effect of traditional Korean medical treatment on fibromyalgia. Case presentation: A patient with fibromyalgia was treated with acupuncture, pharmacopuncture (Bee venom, Hwangryunhaedok-tang), cupping therapy, moxibustion therapy and herbal medicine for 37 days. To reduce the patient's symptoms, we provided herbal medicine three times a day, as well as acupuncture, pharmacopuncture, cupping therapy and moxibustion therapy once a day for 37 days. To evaluate the results of this treatment, we used the Numeral Rating Scale (NRS), Score of Sleeping Quality (SSQ) and Fibromyalgia Impact Questionnaire (FIQ). After treatment, the patient showed that pain was reduced, the score of NRS was improved, FIQ improved from 91 to 69 and SSQ improved from 3 to 1. No adverse reaction was noted. Conclusion: According to the result, traditional Korean medical treatment can be effective and safe for the treatment of fibromyalgia.

• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.259-266
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• 2018

Objectives. Carcinomas of the external auditory canal (EAC) are rare, and management remains challenging. Previous studies seeking prognostic factors for EAC cancers included cancers other than carcinomas. In this study, we analyzed the treatment outcomes of, prognostic factors for, and survival rates associated with specifically squamous cell carcinoma (SCC) of the EAC. Methods. A retrospective review of 26 consecutive patients diagnosed with SCCs of the EAC in a 10-year period was performed in terms of clinical presentation, stage, choice of surgical procedure, and adjunct therapy. Overall survival (OS) and recurrence-free survival (RFS) were calculated and univariate analysis of prognostic factors was performed. Results. The median age of the 26 patients with SCCs of the EAC was 63 years (range, 40 to 72 years), and 16 males and 10 females were included. According to the modified University of Pittsburgh staging system, the T stages were T1 in 11, T2 in six, T3 in four, and T4 in five cases. The surgical procedures employed were wide excision in three cases, lateral temporal bone resection (LTBR) in 17, and extended LTBR in four, and subtotal temporal bone resection in two. Two patients underwent neoadjuvant chemotherapy, and two underwent adjuvant chemotherapy. One patient received preoperative radiation therapy, and eleven received postoperative radiation therapy. Of the possibly prognostic factors examined, advanced preoperative T stage and advanced overall stage were significant predictors of RFS, but not of OS. Conclusion. The advanced T stage and overall stage were associated with decreased survival after surgical treatment in patients with SCC of the EAC, highlighting the importance of clinical vigilance and early detection.

• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.224-232
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• 2018

Objectives. Spiral ganglion neurons (SGNs) include potential endogenous progenitor populations for the regeneration of the peripheral auditory system. However, whether these populations are present in adult mice is largely unknown. We examined the presence and characteristics of SGN-neural stem cells (NSCs) in mice as a function of age. Methods. The expression of Nestin and Ki67 was examined in sequentially dissected cochlear modiolar tissues from mice of different ages (from postnatal day to 24 weeks) and the sphere-forming populations from the SGNs were isolated and differentiated into different cell types. Results. There were significant decreases in Nestin and Ki67 double-positive mitotic progenitor cells in vivo with increasing mouse age. The SGNs formed spheres exhibiting self-renewing activity and multipotent capacity, which were seen in NSCs and were capable of differentiating into neuron and glial cell types. The SGN spheres derived from mice at an early age (postnatal day or 2 weeks) contained more mitotic stem cells than those from mice at a late age. Conclusion. Our findings showed the presence of self-renewing and proliferative subtypes of SGN-NSCs which might serve as a promising source for the regeneration of auditory neurons even in adult mice.

• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.267-274
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• 2018

Objectives. Two main digital signal processing technologies inside the modern hearing aid to provide the best conditions for hearing aid users are directionality (DIR) and digital noise reduction (DNR) algorithms. There are various possible settings for these algorithms. The present study evaluates the effects of various DIR and DNR conditions (both separately and in combination) on listening comfort among hearing aid users. Methods. In 18 participants who received hearing aid fitting services from the Rehabilitation School of Shahid Beheshti University of Medical Sciences regularly, we applied acceptable noise level (ANL) as our subjective measure of listening comfort. We evaluated both of these under six different hearing aid conditions: omnidirectional-baseline, omnidirectional-broadband DNR, omnidirectional-multichannel DNR, directional, directional-broadband DNR, and directional-multichannel DNR. Results. The ANL results ranged from -3 dB to 14 dB in all conditions. The results show, among all conditions, both the omnidirectional-baseline condition and the omnidirectional-broadband DNR condition are the worst conditions for listening in noise. The DIR always reduces the amount of noise that patients received during testing. The DNR algorithm does not improve listening in noise significantly when compared with the DIR algorithms. Although both DNR and DIR algorithms yielded a lower ANL, the DIR algorithm was more effective than the DNR. Conclusion. The DIR and DNR technologies provide listening comfort in the presence of noise. Thus, user benefit depends on how the digital signal processing settings inside the hearing aid are adjusted.