The Natural History of Labyrinthine Hemorrhage in Patients With Sudden Sensorineural Hearing Loss.

To investigate the application of inner ear 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL) accompanied by inner ear hemorrhage. A total of 1252 SSNHL patients who were admitted from January 2010 to April 2018 were included in the study. The patients' clinical features, complete blood counts, coagulation profiles, audiometry data, and MRI scans were retrospectively reviewed. Twenty-four patients had high labyrinth signals on inner ear 3D-FLAIR MRI (24/1252, 1.9%) that were diagnosed as inner ear hemorrhage. One patient had endolymphatic hydrops on the contralesional side. In the 24 patients, pure tone audiometry curves revealed profound deafness (19/24) and flat moderate hearing loss (5/24); most patients had associated vertigo (23/24) and tinnitus (19/24). Patients with SSNHL (N = 24) were treated. Sixteen patients had invalid improvement, 3 patients were markedly improved, 4 patients had effective treatment, and only 1 patient was cured, for a therapeutic efficacy of 33.3% (8/24). Follow-up 3D-FLAIR MRI in patients showed absorbance of labyrinthine hemorrhage and disappearance of the high signal intensity in the inner ear within 2 weeks to 4 months. Inner ear 3D-FLAIR MRI indicate that most cases of inner ear hemorrhage are spontaneous and that high labyrinth signals are absorbed within 4 months. The site of labyrinth hemorrhage is irregular and independent of hearing loss. Conventional treatment is not very effective, and an appropriate therapy for SSNHL requires further investigation.

Diagnostic advantages of intratympanically gadolinium contrast-enhanced magnetic resonance imaging in patients with bilateral Meniere's disease.

PURPOSE: The aim of the study is to probe whether intratympanically gadolinium contrast-enhanced three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging, together with magnetic resonance imaging scoring system of the perilymphatic space, had advantages in diagnosing patients with bilateral Meniere's disease. MATERIALS AND METHODS: Eight patients diagnosed as 'definite' bilateral Meniere's disease and two patients considered as 'possible' Meniere's disease were selected for the current study. All ten patients underwent caloric test, vestibular evoked myogenic potential and intratympanically gadolinium-enhanced magnetic resonance imaging. The perilymphatic space of scanned images were analyzed to investigate the presence of endolymphatic hydrops. The positive rates (bilaterally abnormal patients/patients tested) of the three examinations in the eight patients with bilateral Meniere's disease were calculated respectively. We also selected eight patients with unilateral Meniere's disease as the control group by the method of simple random sampling without replacement. RESULTS: According to the magnetic resonance imaging scoring system, 100% (8/8) of the patients with bilateral Meniere's disease had bilateral endolymphatic hydrops. The positive rates of vestibular evoked myogenic potential and caloric test were 50% (4/8) and 25% (2/8), respectively. There was a significant difference among the positive rates of the three examinations (P<.05). Two patients with 'possible' Meniere's disease had bilateral endolymphatic hydrops by magnetic resonance imaging. Eight patients with unilateral Meniere's disease displayed endolymphatic hydrops of the affected ears. CONCLUSIONS: Intratympanically gadolinium-enhanced magnetic resonance imaging has a relatively high positive rate of exhibiting bilateral endolymphatic hydrops. This technique with the magnetic resonance imaging scoring system is valuable when diagnosing bilateral Meniere's disease.

Endolymphatic space imaging in idiopathic sudden sensorineural hearing loss with vertigo.

OBJECTIVES/HYPOTHESIS: To investigate endolymphatic space images in patients with idiopathic sudden sensorineural hearing loss (ISNHL) and vertigo using three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI). STUDY DESIGN: This is a prospective study of an analysis using the imaging technology of 3D-FLAIR MRI for patients with ISNHL and vertigo. METHODS: 3D-FLAIR MRI was performed 24 hours after intratympanic injection of gadolinium-diethylenetriamine penta-acetic acid. RESULTS: In four of seven cases of ISNHL with vertigo, endolymphatic hydrops were confirmed in the cochlea and/or the vestibule of the affected ears. CONCLUSIONS: The results of the study imply that there may be some relationship between endolymphatic hydrops and ISNHL with vertigo.

[Diagnostic value and clinical application of inner ear imaging after an intratympanic injection of gadolinium for Meniere's disease].

OBJECTIVE: To explore the positive visualization rate of endolymph space in Meniere's disease (MD) by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) and assess its diagnostic value of MD. METHODS: 3D-FLAIR MRI was performed at 24 h after an intratympanic injection of gadolinium diethylenetriamine penta-acetic acid in 51 MD patients. Then the examination results were summarized, analyzed and compared with those of vestibular evoked myogenic potential (VEMP) and glycerol tests. RESULTS: Gadolinium was found in perilymph inside inner ear. Furthermore the border between perilymph and endolymph was visible so that endolymphatic space was distinctly visualized on 3D-FLAIR MRI. Forty-nine (96.1%) patients demonstrated the signs of endolymphatic hydrops. Statistically significant differences existed between the results of 3D-FLAIR MRI and those of VEMP and glycerol tests (P < 0.05). No complication of tympanic membrane perforation or infection was observed. CONCLUSION: After an intratympanic injection of gadolinium, 3D-FLAIR MRI has a higher positive rate in MD patients. Though as an invasive procedure, it has fewer side effects and will become an important diagnostic tool for MD.

Enzymatic preparation of 20(S, R)-protopanaxadiol by transformation of 20(S, R)-Rg3 from black ginseng.

20(S)-protopanaxadiol (PPD(S)) and 20(R)-protopanaxadiol (PPD(R)), the main metabolites of ginsenosides Rg3(S) and Rg3(R) in black ginseng, are potential candidates for anti-cancer therapy due to their pharmacological activities such as anti-tumor properties. In the present study, we report the preparation of PPD(S, R) by a combination of steaming and biotransformation treatments from ginseng. Aspergillus niger was isolated from soil and showed a strong ability to transform Rg3(S, R) into PPD(S, R) with 100% conversion. Furthermore, the enzymatic reactions were analyzed by reversed-phase HPLC, showing the biotransformation pathways: Rg3(S)-->Rh2(S)-->PPD(S) and Rg3(R)-->Rh2(R)-->PPD(R), respectively. In addition, 12 ginsenosides including 3 pairs of epimers, namely Rg3(S), Rg3(R), Rh2(S), Rh2(R), PPD(S) and PPD(R), were simultaneously determined by reversed-phase HPLC. Our study may be highly applicable for the preparation of PPD(S) and PPD(R) for medicinal purposes and also for commercial use.

Attraction of pinewood nematode to endoparasitic nematophagous fungus Esteya vermicola.

The investigations on attraction of nematodes to nematophagous fungi have mostly dealt with the nematode-trapping species. Esteya vermicola is the endoparasitic fungus of pinewood nematode (PWN) with high infection activity. In the present study, the attraction of PWNs to E. vermicola was investigated. It was confirmed that the living mycelia and exudative substances of E. vermicola were attractive to PWN. Compared with the nematode-trapping fungus A. brochopaga as well as nematode-feeding fungus B. cinerea, E. vermicola showed the significantly strongest attraction ability to nematode. It therefore appeared that the attraction ability reflects the dependence of the fungi on nematodes for nutrients. Furthermore, a new method was developed and used in the study to confirm the effect of volatile substances for the attraction of nematode to fungi. The results suggested that the attractive substances were consisted of avolatile exudative and volatile diffusing compounds.

Simultaneous quantification of 19 ginsenosides in black ginseng developed from Panax ginseng by HPLC-ELSD.

A high-performance liquid chromatographic method with evaporative light scattering detection (HPLC-ELSD) has been developed to identify and quantify 19 ginsenosides (Rg(1), Re, Rf, Rb(1), Rc, Rb(2), Rd, F(4), Rg(6), Rk(3), Rh(4), 20(S)-, 20(R)-Rg(3), 20(S)-, 20(R)-Rs(3), Rk(1), Rg(5), Rs(4), and Rs(5)) in black ginseng (BG, Korean white ginseng that was subjected to nine cycles of steam treatment). Ultrasonication is employed for sample preparation, and the analysis is achieved on a Discovery C(18) column using gradient elution of CH(3)CN-H(2)O-CH(3)COOH without buffer in 40min. The method was validated by linearity (r(2)> or =0.9994), precision (92.0-107.5%), intra- and inter-day accuracy (R.S.D.<3.21%), and limit of detection (LOD< or =93ng). The quantification method was applied to analyze the composition of ginsenosides in Korean white, red, and black ginsengs. During the preparatory process of BG, ginsenosides transform into constituents of low polarity by hydrolysis, isomerization, and dehydration at C-20, and hydrolysis also occurs at C-3 or C-6. The validated HPLC method is expected to provide the basis for the quality assessment of ginseng products.

Optimization of ginsenosides hydrolyzing beta-glucosidase production from Aspergillus niger using response surface methodology.

To optimize ginsenosides hydrolyzing beta-glucosidase production from Aspergillus niger, response surface methodology was carried out in two stages. The Plackett-Burman design was achieved to screen the important variables that influence beta-glucosidase production. Among 10 variables (wheat bran, soybean powder, CaCl(2), ginsenosides, KH(2)PO(4), MgSO(4), polyethylene glycol (PEG), medium volume, inoculum size, and stirring speed), it was found that wheat bran, KH(2)PO(4), and stirring speed had significant effect on beta-glucosidase activity due to very low p-values (p<0.05). Subsequently, wheat bran, KH(2)PO(4), and stirring speed were further optimized using central composite design. The optimal beta-glucosidase production was predicted to be 4650.14 U/ml with the combination of factors (wheat bran, 34.51 g/l; KH(2)PO(4), 1.78 g/l; stirring speed, 161.60 rpm/min). Finally, under optimal fermentation conditions, ginsenoside Rb(1) was converted to Rd and F(2) by A. niger within 10 min. Little compound K was detected at 30 min, and finally F(2) was completely transformed to compound K within 8 h. The putative conversion pathway of Rb(1) by A. niger was Rb(1), Rd, F(2), and compound K.

High infectivity of an endoparasitic fungus strain, Esteya vermicola, against nematodes.

Esteya vermicola, as the first recorded endoparasitic fungus of pinewood nematodes, exhibits great potential as a biological agent against nematodes. However, only two strains of this species have been described so far. In this study, we identified a novel endoparasitic fungal strain, CNU 120806, isolated from infected nematodes in forest soil samples during a survey of nematophagous fungi in Korea. This strain showed similar morphological characteristics and infection mode with the two previously described strains of E. vermicola. All strains are characterized by the ability to produce two types of conidiogenous cells and conidia, and to parasitize nematodes with lunate adhesive conidia. Moreover, the CNU 120806 strain showed 100% identity with E. vermicola CBS 115803 when their partial sequences of 28S rRNA gene were compared. Molecular phylogenetic analysis further identified CNU 120806 as a strain of E. vermicola, by clustering CNU 120806 and E. vermicola CBS 115803 into a single subclade. Culture medium influenced the proportion of dimorphic CNU 120806 conidia, and further changed the adhesive and mortality rates of nematodes. The CNU 120806 strain exhibits high infection activity against nematodes on nutrient-rich PDA medium. Almost all tested nematodes were killed within 8 approximately 10 days after inoculation. This study provides justification for further research of E. vermicola, and the application and formulation of this fungus as a bio-control agent against nematodes.