Is There a Relationship Between Bone Quality and Hearing Level?

OBJECTIVES: This study evaluated the correlation between skull bone attenuation on temporal bone computed tomography (CT) and bone mineral density (BMD) of the central skeleton on dual-energy x-ray absorptiometry (DXA) and the correlation between bone quality and hearing level. STUDY DESIGN: Retrospective observational. SETTING: Tertiary referral center. PATIENTS/INTERVENTIONS: One hundred and one ears of 101 patients who underwent temporal bone CT and DXA with pure tone audiometry within 3 months of CT. MAIN OUTCOME MEASURES: Bone quality was measured by both bone attenuation of the clivus and petrous apex by setting a circular region of interest and by the cortical thickness of the occipital bone on CT. Partial correlation analysis was used to assess the correlation between bone quality around the skull on CT and BMD in the central skeleton after adjusting for age and sex. Partial correlations between pure tone audiometry and CT/DXA results were sought. RESULTS: There was no significant correlation between measurements on CT and BMD on DXA. The hearing level partially correlated with BMD on DXA. The average threshold of bone conduction showed a significant correlation with BMD at the femoral neck (correlation coefficient -0.241, p = 0.020) and trochanter (correlation coefficient -0.244, p = 0.018), but there was no significant correlation between the average threshold of bone conduction and BMD at the lumbar spine (p = 0.177-0.332). CONCLUSION: We could not find a relationship between hearing loss and bone quality. Hearing levels can be affected by various factors, so further studies are needed to assess regional temporal bone quality.

Correlation of Nasal Eosinophilia and Response after Nasal Provocation Test in Patients with Nonallergic Rhinitis.

Objectives We aimed to evaluate the relationship between nasal eosinophilia and nasal hyperresponsiveness to allergen extract. Study Design Retrospective chart review. Setting Academic tertiary rhinologic practice. Subjects and Methods We performed allergy tests (skin prick test and multiple allergosorbent test) and nasal cytology for 194 patients with rhinitis symptoms (76 males and 118 females; age, 11-69 years). According to the results, they were classified into 4 groups: group A (allergic rhinitis with eosinophilia, n = 26), group B (allergic rhinitis without eosinophilia, n = 77), group C (nonallergic rhinitis with eosinophilia syndrome, n = 20), and group D (nonallergic rhinitis without eosinophilia, n = 71). We performed a nasal provocation test (NPT) using house dust mite extract and assessed the changes in symptoms and the decrease in acoustic parameters (total nasal volume and minimal cross-sectional area [MCA]). Results Patients in group C were more likely to have severe rhinorrhea and sneezing than those in group D ( P < .001). After NPT, group C had greater aggravation of nasal obstruction than group D ( P < .001). Group C also showed markedly greater MCA changes as compared with group D 15 minutes after the antigen challenge ( P = .002). There was significant correlation between the number of eosinophils and an increase in nasal obstruction ( r = 0.319, P = .0009), rhinorrhea ( r = 0.302, P = .0017), sneezing ( r = 0.219, P = .0241), change in the total nasal volume 15 minutes after NPT ( r = 0.287, P = .0028), and change in the MCA 15 minutes ( r = 0.322, P = .0008) and 30 minutes ( r = 0.250, P = .0098) after NPT. Conclusion In patients with NAR, nasal eosinophilia is associated with provocative response after NPT. Further research should be performed to elucidate the mechanisms that underlie this phenomenon.

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).

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?'