Reproductive characteristics in an understory bamboo and gradual environmental changes after its dieback provide an extended opportunity for overstory tree regeneration in a mixed cool-temperate forest in central Japan.

The reproductive characteristics of understory bamboo and the effects of dieback on overstory tree seedlings through temporal changes in the environment at the forest floor have only been examined in a few bamboo species, due to the unpredictable occurrence of flowering events and long intervals between them but provide valuable information on tree regeneration and succession in a forest with dense dwarf bamboo cover. We investigated environmental conditions and assessed seedlings (< 30-cm tall) of the dwarf bamboo Sasa borealis and overstory tree species at 44-50 measurement points during 2016-2021, which included a S. borealis mass flowering event in 2017. We also conducted seed germination tests to determine germination rates and patterns in S. borealis. Environmental factors affecting seedling recruitment of S. borealis and of overstory trees were analysed using spatiotemporal generalized linear mixed models in the Bayesian framework. We observed gradual temporal changes in the environment, including increasing canopy openness and decreasing maximum height of dead S. borealis culms. The seeds germinated slowly and the emergence of current-year S. borealis seedlings peaked in spring-summer in 2019. The tree seedling density after 2019 increased significantly compared to that before the dieback. The model results suggest that tree seedling establishment was enhanced by increased light availability. Continuous field observation beginning before S. borealis dieback revealed gradually enhanced tree recruitment in response to slow decay of the remaining dead culms and slow recovery of S. borealis. The seedling regeneration pattern of understory bamboo partly contributes to a prolonged opportunity for overstory tree regeneration.

g Factor of the

The gyromagnetic factor of the low-lying E=251.96(9) keV isomeric state of the nucleus ^{99}Zr was measured using the time-dependent perturbed angular distribution technique. This level is assigned a spin and parity of J^{π}=7/2^{+}, with a half-life of T_{1/2}=336(5) ns. The isomer was produced and spin aligned via the abrasion-fission of a ^{238}U primary beam at RIKEN RIBF. A magnetic moment |µ|=2.31(14)µ_{N} was deduced showing that this isomer is not single particle in nature. A comparison of the experimental values with interacting boson-fermion model IBFM-1 results shows that this state is strongly mixed with a main νd_{5/2} composition. Furthermore, it was found that monopole single-particle evolution changes significantly with the appearance of collective modes, likely due to type-II shell evolution.

Diagnóstico diferencial de hernia discal / Diagnostic differences for disc herniation

Disc herniation is a frequent pathology in the radiologist's daily practice. There are different pathologies that can simulate a herniated disc from the clinical and especially the imaging point of view that we should consider whenever we report a herniated disc. These lesions may originate from the vertebral body (osteophytes and metastases), the intervertebral disc (discal cyst), the intervertebral foramina (neurinomas), the interapophyseal joints (synovial cyst) and from the epidural space (hematoma and epidural abscess).

La hernia discal es una patología frecuente en la práctica diaria del radiólogo. Hay distintas patologías que pueden simular una hernia discal desde el punto de vista clínico y especialmente imagenológico que debemos considerar cada vez que informamos una hernia discal. Estas lesiones pueden provenir del cuerpo vertebral (osteofitos y metástasis), del disco intervertebral (quiste discal), de los forámenes intervertebrales (neurinomas), de las articulaciones interapofisiarias (quiste sinovial) y desde el espacio epidural (hematoma y absceso epidural).

Is the 7/2(1)- isomer state of 43S spherical?

We report on the spectroscopic quadrupole moment measurement of the 7/2(1)(-) isomeric state in (16)(43)S(27) [E*=320.5(5) keV, T(1/2)=415(3) ns], using the time dependent perturbed angular distribution technique at the RIKEN RIBF facility. Our value, |Q(s)|=23(3) efm(2), is larger than that expected for a single-particle state. Shell model calculations using the modern SDPF-U interaction for this mass region reproduce remarkably well the measured |Q(s)|, and show that non-negligible correlations drive the isomeric state away from a purely spherical shape.

Skin autofluorescence is associated with severity of vascular complications in Japanese patients with Type 2 diabetes.

AIMS: Skin autofluorescence, a non-invasive measure of the accumulation for advanced glycation end products, has been reported to be a useful marker for diabetic vascular risks in the Caucasian population. The aim of this study was to evaluate associations between skin autofluorescence and vascular complications in non-Caucasian patients with Type 2 diabetes. METHODS: Subjects in this cross-sectional study comprised 130 Japanese patients with Type 2 diabetes. Skin advanced glycation end products were assessed by skin autofluorescence using an autofluorescence reader. Association between skin autofluorescence and severity of vascular complications was evaluated. RESULTS: Of the 130 patients, 60 (46.2%) had microvascular complications such as diabetic retinopathy, neuropathy and nephropathy, 10 (7.7%) had macrovascular complications and 63 (48.5%) had micro- and/or macrovascular complications. Skin autofluorescence increased with severity of vascular complications. Independent determinants of skin autofluorescence were age (ß = 0.24, P < 0.01), mean HbA(1c) in previous year (ß = 0.17, P = 0.03), microvascular complications (ß = 0.44, P < 0.01) and macrovascular complications (ß = 0.27, P < 0.01). Multiple logistic regression analysis revealed that diabetes duration (odds ratio 1.15, P < 0.01), systolic blood pressure (odds ratio 1.04, P = 0.01), skin autofluorescence (odds ratio 3.62, P = 0.01) and serum albumin (odds ratio 0.84, P < 0.01) were independent factors for the presence of vascular complications in these patients. CONCLUSIONS: Skin autofluorescence had independent effects on vascular complications in Japanese patients with Type 2 diabetes. This indicates that skin advanced glycation end products are a surrogate marker for vascular risk and a non-invasive autofluorescence reader may be a useful tool to detect high-risk cases in non-Caucasian patients with diabetes.

Imágenes neuro­oftalmológicas / Neuro-ophtalmological images

El desarrollo de la resonancia magnética ha producido nuevos tipos de imágenes que pueden ser de utilidad en pacientes con manifestaciones visuales. Las imágenes estructurales potenciadas en T1 pueden ser procesadas, mediante diferentes tipos de software, para la obtención de nuevas imágenes que permiten separar distintas estructuras (segmentación), realizar estudios volumétricos cerebrales (volumetría) y medir el grosor de la corteza en distintas áreas, independiente de la complejidad de la superficie cerebral (espesor cortical). Además es posible "deformar" los cerebros para realizar estudios comparativos con poblaciones normales (normalización). Las imágenes de difusión muestran la movilidad de las molé- culas de agua al interior del cerebro, información que utilizamos para reconstruir los tractos neuronales principales (tractografía) y para dimensionar indirectamente la conectividad de distintas áreas (difusión multidireccional). Mediante resonancia magnética funcional es posible localizar las áreas elocuentes cerebrales (resonancia magnética funcional convencional) o representar la conexión funcional de un área cerebral específica (resonancia magnética resting state)

The development of MRI has led new types of images that can be useful in patients with visual manifestations. T1 structural images can be processed by different software to obtain new images for partitioning different neurological structures (segmentation), to do brain volumetric studies (volumetry) and to measure the cortical thickness in an independent way of the complexity of the brain surface (cortical thickness). It is also possible to "warp" the brains for comparative studies with normal populations (normalization). Diffusion images shows the mobility of water molecules in the brain that is used to reconstruct the main neural tracts (tractography) and to measure indirectly the connectivity of different areas (multidirectional diffusion). Functional magnetic resonance imaging can identify eloquent brain areas (tipical functional magnetic resonance) or represent the intrinsic connectivity of specific brain areas (resting state fMRI)

Desarrollo y puesta en marcha de software de tractografía / Development and start-up of a tractography software

Diffusion weighted MRI can measure the random motion of water molecules in biological tissue. These motions are captured using magnetic gradients that dephase the precession of water molecules that move along the direction of the gradient. Dephasings show up as small attenuations in signal intensity. This information can be used in tissues such as muscles, spine, medulla and white matter to measure the ani-sotropy and assess fiber integrity. In this work, a new software for the post-processing of diffusion weighted MRI is presented. The software can read dataseis from a variety of scanners. Diffusion is modeled using ellipsoids that are represented mathematically by means of a tensor, estimated from entry dataset. Various indices such as diffusion tensor eigenvalues, fractional anisotropy, types of anisotropy, mean diffusivity, and principal directions are computed. Results are interactively visualized by using axial planes or a three-dimensional approach. The software includes a nerve fiber tracing module. This tool works on PC-based workstations through a graphical user interface or by using the command line.

Las imágenes de resonancia magnética sensibilizadas a difusión son capaces de medir el movimiento aleatorio de las moléculas de agua dentROI de los tejidos biológicos. Estos movimientos son capturados usando gradientes en el campo magnético que introducen desfases entre moléculas que se mueven a lo largo de la dirección del gradiente. Estos desfases aparecen como pequeñas atenuaciones en la señal. Esta información puede ser usada en tejidos como músculos, médula o sustancia blanca para medir la anisotropía y tener una medida de la integridad de las fibras nerviosas. En este trabajo mostraremos un nuevo software de postproceso de las ID. Este programa es capaz de leer datos de varios resonadores. Se modela la difusión usando elipsoides que a su vez se representan con un tensor, estimado a partir de los datos de entrada. Varios índices tales como valores propios del tensor, anisotropía fraccional, tipo de anisotropía, difusión media y direcciones principales pueden ser calculados. Los resultados son visualizados interactivamente en cortes axiales y de forma tridimensional. El software incluye un módulo de trazado de fibras nerviosas. Esta herramienta funciona en computadores de escritorio y puede ser utilizada interactivamente a través de una interfaz gráfica o bien usando la línea de comando.

Obtención de coordenadas Talairach a partir de mapas corticales de área visual con resonancia magnética funcional / Getting Talairach coordinates from the fMRI mapping of visual cortex

Functional magnetic resonance imaging gives detailed information on the location of brain activity. Due to the functional-anatomic difference between patients, discrepancies arouse concerning the location of activation areas. To solve this problem, a standard positioning system called Talairach Coordinates was used. The fMRI mapping of visual cortex was performed in 14 healthy volunteers, using colored circles visual stimulation. Using fMRI post processing software, a combined image of the 14 volunteers fMRI was computed. The main activation voxel is (16, -93, 7), that corresponds to Brodmann area 17 (primary visual area V1). Correlation of the primary visual area (V1) obtained through fMRI with Brodmann area 17, only proven from the classical literary neurophysiological viewpoint, was confirmed.

La resonancia magnética funcional entrega información detallada sobre la localización de la actividad cerebral. Debido a la diferencia anátomo-funcional entre los pacientes, se producen discrepancias en la localización de las zonas de activación obtenidas. Para solucionar esto, se utiliza un sistema de posicionamiento estándar denominado coordenadas Talairach. Se realizó resonancia magnética funcional con estimulación visual de círculos de colores en 14 voluntarios de ambos sexos. Mediante postproceso con software especializado, se obtuvo una imagen combinada de los 14 estudios, en la cual el voxel de mayor activación (16, -93, 7) corresponde al área de Brodmann 17 (ßrea visual primaria V1). Se confirma la correlación del área funcional visual primaria (V1) obtenida con resonancia magnética funcional y el área 17 de Brodmann, demostrada sólo desde el punto de vista teórico en los textos de neurofisiología clásicos.

Uso combinado de resonancia magnética funcional (fMRI) y tractografía para seleccionar tractos específicos de sustancia blanca: experiencia preliminar / Combined use of functional magnetic resonance imaging (FMRI) and tractography to select specific white matter fibers: a preliminary study

Tractography is a magnetic resonance imaging post processing technique, that reveals white matter tracts. The selection of specific tracts is a current research topic in medical imaging. Fibers of a male patient were chosen by using a ROÍ selection generated by activation of the primary motor cortex area (SM1) of the left hand (fMRI), and fiber tracts related to that cortex area (efferent fibers) were obtained. Fibers obtained through this procedure present the typical arrangement of the corticospinal tract motor fibers: originated from the motor cortex, they descend through the posterior limb ofthe internal capsule to converge to the cerebral peduncle until the pons. We have concluded that it is possible to select the corticospinal tract by using a functional Magnetic Resonance Imaging to generate ROÍ selection.

La tractografía es una técnica de postprocesamiento de imágenes de resonancia magnética, que permite visualizar tractos de sustancia blanca. La selección de tractos específicos es un tema actual de investigación a nivel mundial. En un paciente se seleccionaron las fibras utilizando ROÍ generada mediante activación del área motora primaria de la mano izquierda (fMRI), obteniéndose asilas fibras del tracto motor específicas de esta área (fibras eferentes). Las fibras obtenidas presentan la disposición clásica de las fibras motoras en el tracto corticoespinal: se inician en la corteza motora, descienden por el brazo posterior de la cápsula interna integrándose al pedúnculo cerebral y visualizándose hasta la parte del tronco cerebral. Se concluye que es posible seleccionar el tracto corticoespinal mediante ROÍ generado con resonancia magnética funcional.

Initial functional status predicts infections during steroid therapy for renal diseases.

BACKGROUND AND AIM: Corticosteroid therapy is an effective way of treatment for many renal diseases, however, it is sometimes associated with infections. Our aim is to identify useful predictive markers of infection during steroid therapy. METHODS: We examined 121 patients (M/F = 71/50, mean age 43.8, range 15 - 82 years) who were treated with corticosteroids (IgA nephropathy in 51, minimal-change disease in 17, membranous nephropathy in 16 rapidly progressive glomerulonephritis (RPGN) in 13, lupus nephritis in 12 and other disorders in 12). Karnofsky's performance score (KPS) was employed to assess the physical functional status at the time of diagnosis. Infections were defined as conditions that required more than 1-week care, and those that caused the patient's death. RESULTS: Nineteen patients (15.7%) had infections during treatment. A logistic multivariate analysis showed significant correlations between infection and the use of immunosuppressive agents (relative risk RR = 7.7, p = 0.0265), ages of 52.9 years or more (RR = 13.5, p = 0.0026), initial number of lymphocytes (Lym) less than 1.250/microl (RR = 14.2, p = 0.0011), and KPS less than 77.4 (RR = 12.1, p = 0.0020). All correlations with infection were independent of all the other variables listed above. CONCLUSION: KPS, along with age, Lym and the use of immunosuppressive agents, are useful for the prediction of infectious complications during steroid therapy.

Cálculo de tiempos T1 y T2 in vitro / Time calculation in vitro T1 and T2

El objetivo del trabajo consiste en cuantificar los valores de los tiempos de relajación T1 y T2 a través de una simple modificación de las secuencias convencionales. En forma experimental se obtuvieron imágenes in vitro en un resonador magnético de 1.5T de diferentes tejidos biológicos correspondientes a músculos, lípidos y agua, a partir de las cuales se obtuvieron las respectivas curvas T1 y T2. Las secuencias utilizadas corresponden a espín-eco para las curvas T1 mediante la variación del TR y turbo espíneco para las curvas T2, por medio de la variación del TE. Finalmente los parámetros T1 y T2 de las respectivas curvas de relajación longitudinal y transversal se obtuvieron mediante el ajuste con las curvas exponenciales teóricas. Los valores T1 resultantes fueron 951 ms para el músculo, 238 ms para los lípidos y 2813 ms para el agua. Los valores T2 resultantes fueron 71ms para el músculo, 81 ms para los lípidos y 704 ms para el agua. Lo anterior demuestra la factibilidad de calcular estos parámetros, con el objetivo de ser utilizados en los diferentes análisis cuantitativos de las imágenes por resonancia magnética.

Close relationship of plasminogen activator inhibitor-1 4G/5G polymorphism and progression of IgA nephropathy.

BACKGROUND: The plasminogen activator inhibitor-1 (PAI-1) 4G/4G genotype influences the development of diabetic nephropathy and lupus nephritis. However, the association of the PAI-1 4G/4G genotype and IgA nephropathy (IgAN) has not been investigated. SUBJECTS AND METHODS: The PAI-1 and ACE polymorphisms were examined in 270 healthy volunteers and 202 biopsy-proven IgAN patients, including 117 untreated IgAN patients who had an annual health check, allowing an estimation of the time of onset of overt proteinuria and/or hematuria. The relationship between the gene polymorphisms and the pathogenesis of IgAN were examined in 202 IgAN patients and the relationship between the gene polymorphisms clinical and pathohistological findings were examined in 117 untreated IgAN patients cross-sectionally at the time of renal biopsy. RESULTS: 202 IgAN patients and 117 untreated IgAN patients did not have different frequencies in PAI-1 4G/5G (4G/4G : 4G/5 : 5G/5G = 82 : 90: 30, 45 : 55 : 17) and ACE I/D (DD : ID : II = 41 : 82 : 79, 21 : 54 : 42) gene polymorphisms compared with 270 healthy volunteers (4G/4G : 4G/5 : 5G/5G = 99 : 124 : 47, DD : ID : II = 53 : 106 : 111). However, IgAN with 4G/4G had significantly more advanced histological changes than IgAN with 4G/5G or 5G/5G both in glomerular and tubulointerstitial findings (p < 0.0005). The disease duration in IgAN with 4G/4G was shorter than in IgAN with 4G/5G + 5G/5G (6.22 +/- 6.38 and 8.80 +/- 9.79 years, respectively, p < 0.05). Creatinine clearance (Ccr) in IgAN with 4G/4G was significantly lower than IgAN with 4G/5G or 5G/5G (72.3 +/- 26.5 and 82.4 +/- 22.8 ml/min, respectively, p < 0.05). The mean urinary protein excretion in IgAN with 4G/4G was significantly more than in IgAN with 4G/5G or 5G/5G (1.10 +/- 1.48 and 0.70 +/- 1.01 g/day, respectively, p < 0.05). There was no difference between IgAN with the DD ACE genotype and IgAN with ID + II genotypes in either the clinical or histopathological findings. CONCLUSION: PAI-1 polymorphism is not associated with genesis of IgA nephropathy, but may be a risk factor for the progression of IgA nephropathy in Japanese.

Insulin resistance highly associates with hypertension in IgA nephropathy.

BACKGROUND: Insulin resistance has been reported to induce hypertension. Previous studies described that there was no relationship between insulin resistance and hypertension in patients with chronic renal diseases with mild to moderate renal dysfunction. The aim of the present study is to clarify the relationship between insulin resistance and blood pressure, renal function, histopathological changes and other characteristics in IgA nephropathy (IgAN). METHODS: Eighty-eight IgAN patients were included in this cross-sectional study. Hypertension was diagnosed according to the WHO/ISH criteria. Insulin resistance was evaluated by homeostasis model assessment (HOMA-IR). RESULTS: Male gender, age, body mass index, serum creatinine, urinary protein excretion, triglycerides and HOMA-IR were positively correlated with hypertension. C(Cr), serum albumin and HDL cholesterol were negatively correlated with blood pressure by Spearman's simple correlation test. By logistic multivariate analysis, C(Cr), insulin resistance, age and male gender were significantly correlated with hypertension, independently of all other variables. CONCLUSIONS: Insulin resistance is not directly related to renal dysfunction, but is also independently associated with hypertension in IgAN. Since hypertension is considered as a risk factor for renal disease progression, insulin resistance may be an indirect deteriorating factor for IgAN. To identify and improve insulin resistance may be another therapeutic target in the clinical management of IgAN.

Sudden deafness: long-term follow-up and recurrence.

We examined the long-term outcome for patients with idiopathic sudden sensorineural hearing loss (sudden deafness), including the incidence of recurrence of sudden deafness. The subjects were 1,798 individuals who came to Nagoya University hospital within 2 weeks of the onset of unilateral sudden deafness. Only 14 of the patients had a history of being diagnosed with sudden deafness. After their visit to our hospital, one patient had a recurrence in the ipsilateral ear and four patients experienced sudden deafness in the contralateral ear. We performed hearing examinations on 88 patients who revisited our hospital more than 10 years after unilateral sudden deafness. Of these patients, there was one with a recurrence in the ipsilateral ear and one with sudden deafness in the contralateral ear. Thus, in this series the recurrence of sudden deafness was rare.

Differentiation of human acute myeloid leukaemia cells in primary culture in response to cotylenin A, a plant growth regulator.

Cotylenin A, which has a diterpenoid tricarbocyclic skeleton, has been isolated as a plant growth regulator, has been shown to affect several physiological processes of higher plants and have differentiation-inducing activity in several myeloid leukaemia cell lines. We examined the effect of cotylenin A on the differentiation of leukaemic cells that were freshly isolated from acute myeloid leukaemia (AML) patients in primary culture. Cotylenin A significantly stimulated both functional and morphological differentiation of leukaemia cells in 9 out of 12 cases. This differentiation-inducing activity was more potent than those of all-trans retinoic acid and 1alpha,25-dihydroxyvitamin D3 (VD3). Treatment with a combination of cotylenin A and VD3 was more effective than cotylenin A or VD3 alone at inducing the monocytic differentiation of AML cells.

Induction of the monocytic differentiation of myeloid leukaemia cells by cotylenin A, a plant growth regulator.

Regulators that play an important role in the differentiation and development of plants or invertebrates may also affect the differentiation of human leukaemia cells through a common signal transduction system, and might be clinically useful for treating acute myeloid leukaemia. Cotylenin A has been isolated as a plant growth regulator. We examined the effects of cotylenin A on the differentiation of several myelogenous leukaemia cells, and found that cotylenin A is a potent and novel inducer of the monocytic differentiation of human myeloid leukaemia cells. Cotylenin A induced the functional and morphological differentiation of myeloblastic and promyelocytic leukaemia cells, but did not effectively induce the differentiation of monocytoid leukaemia cells. Cotylenin A-induced differentiation was not affected by several inhibitors of signal transduction, suggesting that this inducer exhibits a unique mode of action.

[Analysis of 200 university hospital hearing aid clinic patients].

We statistically studied patients who visited our hearing aid clinic to determine what segment of the population may benefit from hearing aids. Subjects were 200 patients from 5 to 89 years of age who had visited the Hearing Aid Clinic of Otorhinolaryngology, Nagoya University Hospital, between January 1998 and March 2000. This clinic lent out hearing aids. Subjects were divided into 2 groups those having their own hearing aids either new or earlier (HA group) and those giving up hearing aids after a trial (non-HA group). Mean better hearing levels in pure tone average were 50.6 dB in the HA group and 44.5 dB in the non-HA group. Mean better maximum speech recognition scores were 81.5% in the HA group and 85.3% in the non-HA group. The distribution of better hearing has shown that patients with mild hearing loss (better pure tone average < 40 dB) account for more than a quarter of all hearing aid clinic patients. Among patients with mild hearing loss, 60% had their own hearing aids. The need for rehabilitation in the mild hearing loss population thus appears large. Their intent to wear hearing aids influenced whether patients agreed or declined hearing aids after a trial. The period from use until patients made a decision was 2 weeks in 65% of those declining use and 35% of those agreeing to use. Over 15% of those agreeing called for a trial period longer than 8 weeks. Hearing aid trials provide useful information for both patients and surgeons before choosing surgery for a difficult ear condition. In this research, 18 patients needed counseling about both amplification and surgery. Bridging between ear surgery and hearing aid wearing is a vital role of hearing aid clinics at university hospitals.

Role for matrix metalloproteinase 9 after focal cerebral ischemia: effects of gene knockout and enzyme inhibition with BB-94.

It has been shown recently that matrix metalloproteinases (MMPs) are elevated after cerebral ischemia. In the current study, we investigated the pathophysiologic role for MMP-9 (gelatinase B, EC.3.4.24.35) in a mouse model of permanent focal cerebral ischemia, using a combination of genetic and pharmacologic approaches. Zymography and Western blot analysis demonstrated that MMP-9 protein levels were rapidly up-regulated in brain after ischemic onset. Reverse transcription polymerase chain reaction showed increased transcription of MMP-9. There were no differences in systemic hemodynamic parameters and gross cerebrovascular anatomy between wild type mice and mutant mice with a targeted knockout of the MMP-9 gene. After induction of focal ischemia, similar reductions in cerebral blood flow were obtained. In the MMP-9 knockout mice, ischemic lesion volumes were significantly reduced compared with wild type littermates in male and female mice. In normal wild type mice, the broad spectrum MMP inhibitor BB-94 (batimastat) also significantly reduced ischemic lesion size. However, BB-94 had no detectable protective effect when administered to MMP-9 knockout mice subjected to focal cerebral ischemia. These data demonstrate that MMP-9 plays a deleterious role in the development of brain injury after focal ischemia.

Air-bone gap and resonant frequency in large vestibular aqueduct syndrome.

BACKGROUND: Conductive hearing loss is occasionally recognized in large vestibular aqueduct (LVA) syndrome; however, the incidence rate and the cause are not known. OBJECTIVE: To compare air and bone conduction levels between patients with LVA syndrome and those with idiopathic sudden sensorineural hearing loss, and to investigate the cause of the air-bone gap. STUDY DESIGN: Retrospective study. SETTING: The patients were treated at a tertiary referral center. PATIENTS: Twenty-eight ears of 15 patients with LVA syndrome and 28 ears of patients with idiopathic sudden sensorineural hearing loss were examined. The latter patients were selected from a computerized database to match the former patients in air conduction levels. MAIN OUTCOME MEASURES: Pure-tone audiometry, multiple frequency tympanometry, acoustic reflex, otoacoustic emission, vestibular evoked myogenic response. RESULTS: The air-bone gap in patients with LVA syndrome was always larger than that in patients with idiopathic sudden sensorineural hearing loss with the same air conduction level. The resonant frequency in patients with LVA syndrome was rather low compared with that in normal control subjects, in contrast to the finding that resonant frequency was significantly high in patients with otosclerosis. CONCLUSIONS: An air-bone gap exists to some degree in almost all patients with LVA syndrome. The air-bone gap may not be associated with the movement restriction of the stapes as it is with otosclerosis.