Development of Sound Field Audiometry System for Small Audiometric Booths and Comparison of Its Equivalence With Traditional System

Objectives@#. Sound field (SF) audiometry tests are usually conducted in audiometric booths measuring greater than 2×2 m in size. However, most private ENT clinics carry about 1×1-m-sized audiometric booths, making SF audiometry testing difficult to perform. The aims of this study were to develop an SF audiometry system for use in smaller audiometric booths and compare its performance with traditional system. @*Methods@#. The newly developed SF audiometry system can yield an SF signal at a distance of about 30 cm from the subject’s ears. Its height can be adjusted according to the subject’s head height. We compared SF hearing results between the new SF system and the traditional SF audiometry system in 20 adults with normal hearing (40 ears) and 24 adults with impaired hearing levels (38 ears) who wore hearing aids. Comparative parameters included warble tone audiometry threshold, a speech reception threshold (SRT), and a speech discrimination score (SDS). For statistical analysis, paired t-test was used. The equivalence of both SF systems was tested using two one-sided test (TOST) with a margin of 5 dB (normal hearing participants) and 10 dB (hearing aids wearing participants). @*Results@#. Among participants with normal hearing, warble tone hearing thresholds of 0.5, 1, 2, and 4 kHz, average values of these four frequencies, and SRT were similar between the two systems (all P>0.05). Participants with hearing aids showed similar warble tone threshold and SRT (P>0.05) in both systems except for threshold of 4 kHz (P=0.033). SDS was significantly higher in the newly developed system (P<0.05). TOST results showed equivalent SF audiometry results using either system. @*Conclusion@#. Audiometric results of the newly developed SF audiometry system were equivalent to those of a traditional system. Therefore, the small SF audiometry system can be used at small audiometric booths present in most private ENT clinics.

The Korean Version of the Theory of Mind Test and the Early Development of the Theory of Mind in Children with Cochlear Implant / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Theory of Mind (ToM) refers to the ability humans have for recognizing the mental states of others and for predicting or explaining other people’s behavior. ToM is an essential ability people have for living with other people because it influences social relations, and the deaf children have been reported to have problems in ToM. As there are no ToM assessment tools in Korea, the purpose of this study was to establish such a version and to examine the early development of ToM of children with cochlear implant (CI).SUBJECTS AND METHOD: The original tools for ToM assessment were translated in Korean and the reliability and validity of the Korean version of ToM assessment tools were investigated with fifty normal hearing (NH) children. The early development of ToM of sixteen children with CI was compared with that of age-matched children with NH.@*RESULTS@#The reliability of Korean version of ToM assessment tools was determined by tests for internal consistency and test-retest reliability. The validity of the tools was also evaluated by the tests for criterion-related validity and concurrent validity. There was no significant difference in ToM between children with CI and those with NH.@*CONCLUSION@#The Korean version of ToM assessment tools was established and the assessment showed that the early development of ToM of deaf children, who received early intervention using CI, was comparable to that of NH children.

The Korean Version of the Theory of Mind Test and the Early Development of the Theory of Mind in Children with Cochlear Implant / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Theory of Mind (ToM) refers to the ability humans have for recognizing the mental states of others and for predicting or explaining other people’s behavior. ToM is an essential ability people have for living with other people because it influences social relations, and the deaf children have been reported to have problems in ToM. As there are no ToM assessment tools in Korea, the purpose of this study was to establish such a version and to examine the early development of ToM of children with cochlear implant (CI). SUBJECTS AND METHOD: The original tools for ToM assessment were translated in Korean and the reliability and validity of the Korean version of ToM assessment tools were investigated with fifty normal hearing (NH) children. The early development of ToM of sixteen children with CI was compared with that of age-matched children with NH. RESULTS: The reliability of Korean version of ToM assessment tools was determined by tests for internal consistency and test-retest reliability. The validity of the tools was also evaluated by the tests for criterion-related validity and concurrent validity. There was no significant difference in ToM between children with CI and those with NH. CONCLUSION: The Korean version of ToM assessment tools was established and the assessment showed that the early development of ToM of deaf children, who received early intervention using CI, was comparable to that of NH children.

Peer Relations in Children with Cochlear Implants / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Children who received cochlear implants (CIs) in early age can achieve age-appropriate language ability and can be educated in the classroom alongside normal hearing (NH) peers. However, what is rarely investigated is their relations with NH peers in the classroom. The purpose of this study was to examine the peer relations of children with CIs. SUBJECTS AND METHOD: Peer relations were examined using a peer relation scale test that included support, intimacy, recognition, conflict, and competition. Participants were 25 children who received their first CI before 3.5 years of age. Their peer relations were compared with those of 129 children with NH. RESULTS: Children with CIs evaluated themselves as having good peer relations, but their perception of peer relations varied according to gender and language ability. CI boys with language delay perceived lack of support and intimacy, whereas CI girls with language delay perceived more conflict than NH children. On the other hand, CI children with normal language ability showed no differences in their peer relations from NH children. CONCLUSION: Early CI surgery and intensive language rehabilitation can prevent peer problems and promote adjustment in school life for children with CI.

Interpersonal Competence in College Students with Cochlear Implants: A Preliminary Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: ObjectivesZZAlthough many studies have shown that cochlear implantation promotes restoration of adequate hearing and verbal ability, there is little research showing whether patients with cochlear implants (CI) adapted well to the society by forming a good interpersonal relationship. The purpose of this study was to investigate the interpersonal competence of college students who acquired good verbal ability through CI. SUBJECTS AND METHOD: Interpersonal competence was examined using the Korean version of interpersonal competence questionnaire. Participants were 23 college students with CI who had good verbal communication abilities. Their interpersonal competence was compared to that of 28 college students with normal hearing (NH). To identify the factors contributing to the interpersonal competence, regression analysis was performed using speech perception, vocabulary and speech intelligibility as independent variables. RESULTS: College students with CI showed significantly weaker interpersonal competence than those with NH. Among 5 sub-factors of interpersonal competence, assertion and conflict management were not significantly different between two groups and initiation, caring others, and appropriate disclosure of CI group were significantly weaker than NH group. But college students with CI who had normal vocabulary and Speech Intelligibility Ratings score of 5 showed good interpersonal competence, which was comparable to those with NH. CONCLUSION: College students with CI who acquired good verbal communication ability demonstrates lower interpersonal competence than those with NH. Therefore, it is necessary to support them to improve interpersonal competence as well as speech-language ability.

An Acute Pulmonary Embolism Accompanying Greater Saphenous Vein Thrombosis / 대한내과학회지

Pulmonary embolism is most commonly related to deep vein thrombosis of the lower extremities. However, recent studies show that the thrombosis of superficial veins can also progress to deep vein thrombosis and pulmonary embolism. To our knowledge, there is no Korean report of pulmonary embolism associated with superficial vein thrombosis. We experienced an 82-year-old woman complaining of dyspnea and chest pain. On chest dynamic computed tomography (CT), pulmonary embolism was diagnosed. To evaluate the origin of the pulmonary embolism, abdominal CT, Doppler ultrasonography, and ascending venography of both lower extremities were done. We found no deep vein thrombosis, while thrombus of the proximal left greater saphenous vein was seen. We report a case of pulmonary embolism accompanying greater saphenous vein thrombosis without deep vein thrombosis.

Pap smear screening for small cell carcinoma of the uterine cervix: a case series and review of the literature / 부인종양

OBJECTIVE: Small cell carcinoma of the uterine cervix (SMCC) is extremely rare, and an aggressive disease that proliferates rapidly. It was often reported that the diagnostic accuracy of cytologic smears in diagnosing SMCC was low. This is a report of the Severance Hospital experience with the patients suffering from SMCC. METHODS: Twenty-seven patients with small cell carcinoma of the uterine cervix were diagnosed and treated at the Severance Hospital from November 1991 to January 2010. The data were analyzed retrospectively, based on the available charts and pathology reports. Various fields, such as chief complaints and symptoms present at first clinic visit, age, International Federation of Obstetrics and Gynecology (FIGO) clinical stage, treatment modality, the 5-year overall survival rate, and recurrence rate were investigated. RESULTS: Among the 27 patients diagnosed with small cell carcinoma of the uterine cervix, 18 of them (66.7%) presented with symptoms, including vaginal bleeding, at the first clinic visit, and the remaining 9 patients (33.3%) showed abnormal Pap smear screening in the process of their routine health check-up. The median age of the patients was 54 years (range, 24 to 77 years). FIGO stage IIB was the most common stage (11 of 27 patients). The 5-year overall survival rate of 21 patients, who could be followed up, was 57.2%. Six patients showed recurrence after remission, and the mean disease free interval of them was 9.2 months (range, 6 to 11 months). Abnormal Pap smear screening results of 9 patients was investigated, and the diagnostic accuracy of the cytologic findings was 22.2%. CONCLUSION: Our study was consistent with the concept that Pap smear screening might not be helpful in early diagnosis of SMCC considering its low diagnostic accuracy. Further large-scale multicenter prospective studies are definitely needed in order to produce abundant information about optimal therapy and diagnosis.

Transcriptome Analysis of the Effects of Gomisin A on the Recovery of Carbon Tetrachloride-Induced Damage in Rat Liver / 한국실험동물학회지

Gomisin A possesses a hepatic function-facilitating property in liver-injured rats. Its preventive action on carbon tetrachloride-induced cholestasis is due to maintenance of the function of the bile acids-independent fraction. To investigate alterations in gene expression after gomisin A treatment on injured rat liver, DNA microarray analyses were performed on a Rat 44K 4-Plex Gene Expression platform with duplicated reactions after gomisin A treatment. We identified 255 up-regulated and 230 down-regulated genes due to the effects of gomisin A on recovery of carbon tetrachloride-induced rat liver damage. For functional characterization of these genes, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes biochemical pathways analyses were performed. Many up-regulated or down-regulated genes were related to cell cycle or focal adhesion and cell death genes, respectively. Our microarray experiment indicated that the liver repair mechanism induced by gomisin A was strongly associated with increased gene expressions related to cell cycle and suppression of the gene expression related in cell death.

Development of Group Therapy Program for North Korean Refugees with Posttraumatic Stress Disorder and Pre-Study on Its Effect / 신경정신의학

OBJECTIVES: We evaluated the design, application, and preliminary effect of a new group therapy program for assisting the psychological adaptation of North Korean refugees with posttraumatic stress disorder (PTSD). METHODS: We recruited 16 female participants from the student body of Hanawon (North Korean refugees) or K city refugee residents, both governed by the Ministry of Unification. Of the participants, 11 scored more than 28 points, the cut-off score, on the MMPI-II PTSD Keane (PK) scale. Another 5 females, who had been diagnosed with PTSD and received treatment, were included in the study. We divided the participants into 2 groups, each of whom participated in group therapy 10 times. Group (A) consisted of 8 Hanawon refugees, while the other group (B) consisted of 8 refugee residents of K City. To examine the therapy's effects, we utilized the Beck Depression Inventory, Beck Anxiety Inventory, Self-esteem Scale, and Impact of Event Scale-Revised, both before and after treatment. We analyzed the results using paired t-tests and repeated measures. RESULTS: Anxiety scores decreased significantly in group A after the group therapy (t=5.04, pbeta.01 ; t=5.44, pbeta.01). In Group B, there were no statistically significant changes on any scales after the treatment. Furthermore, there were no significant differences between the two groups on any measures, but group A showed lower mean SES scores and higher mean BDI and BAI scores than did group B. CONCLUSION: This was a preliminary application of this newly designed group therapy program for aiding the psychological adaptation of North Korean refugees, utilizing a small group of refugees with PTSD. In spite of many shortcomings and poor results, we expect further refinement and research of into treatment modalities despite this challenging developments.

Delayed allograft rejection by the suppression of class II transactivator

We examined the effect of class II transactivator (CIITA) down-modulation on allograft rejection. To inhibit the function of CIITA, we constructed a series of CIITA mutants and found one exhibiting the dominant-negative effect on the regulation of major histocompatibility complex (MHC) class II expression. To test whether the CIITA dominant-negative mutant reduces immunogenecity, CIITA-transfected melanoma cells were injected into allogeneic host and assessed for immune evading activity against host immune cells. We demonstrated that the CIITA dominant-negative mutant allowed tumor nodules to develop earlier in the lung than control by this tumor challenge study. Furthermore, skin grafts deficient for CIITA also survived longer than wild-type in allogeneic hosts. Both the tumor challenge and skin graft studies suggest the inhibition of CIITA molecules in donor tissue would be beneficial to the control of allo-response.

A Case of patients in whom Endometrial adenocarcinoma was diagnosed while on therapy with Tibolone / 대한산부인과학회지

Tibolone (Livial, NV Organon, Oss, Netherlands) is a synthetic steroid which exhibits estrogenic, progestogenic and androgenic activity. In the endometrium, tibolone dose not have estrogenic activity, but dose have intrinsic progestogenic activity. Therefore, it dose not stimulate the endometrial tissue which usually undergoes atrophy. Tibolone has been associated with a relatively low incidence of vaginal bleeding and endometrial hyperplasia. Recently. a few reports have been published even less frequently describing invasive endometrial cancer during tibolone therapy. We report a case of histologically diagnosed adenocarcinoma of the endometrium in women using tibolone. Although we do not suggest causability between the use of tibolone and the development of endometrial malignancy, but we should alert physicians to thorough investigation in patients presenting with vaginal bleeding and the increase of endometrial thickness by sonogram while on tibolone.

A Case of Angioleiomyoma of Retroperitoneum / 대한산부인과학회지

Angioleiomyoma is a rare benign soft tissue tumor that originates from smooth muscle cells and contains thick-walled blood vessels. Few cases of angioleiomyoma have been described at sites other than the extremities and head. The female genital tract is rarely involved. We have experienced a case of retroperitoneal angioleiomyoma with abnormal MRI and CT findings, which was confused with ovarian malignancy.

CD24 Expression in Gastric Adenocarcinoma Is Associated with Tumor Invasiveness

BACKGROUND: CD24, also referred to as the heat stable antigen in mice, is a glycosyl phosphatidylinositol- linked glycoprotein expressed by thymocytes, B cells, neutrophils and immature neuronal cells. It has been recently observed in a variety of human malignancy. Here, we demonstrated the expression of CD24 in gastric adenocarcinomas. METHODS: A total of 40 gastric adenocarcinomas and 20 tubular adenomas were immunohistochemically examined for the expression of CD24 and matrix metalloproteinase-2 (MMP-2) proteins. The immunoreactivity of CD24 was semiquantitatively scored (0, 1+, 2+) and compared with clinicopathologic variables and MMP-2 expression in tumor cells. RESULTS: CD24 was rarely expressed in normal gastric tissue and not expressed in tubular adenoma. In contrast, a moderate/strong expression (2+) of CD24 was observed in 25% of gastric adenocarcinomas, and 30% cases showed a weak CD24 staining (1+). Moreover, CD24 expression was significantly correlated with the depth of tumor invasion and MMP-2 expression. CONCLUSION: These results suggest that the aberrant expression of CD24 in gastric adenocarcinomas might be associated with tumor progression and invasiveness.

An Experiment to Test Effects of an Educational Program on Prevention of Smoking in Middle School Students / 기본간호학회지

PURPOSE: This study was to evaluate effect of an educational program based upon experiment for smoking prevention in middle school students. METHOD: A quasi-experimental design was used. The participants were 107 middle school students (53 in the experimental group, 54 in the control group). Students in the experimental group participated in three 45-minute educational programs over a period of 2 weeks. The dependent variables were measured before and 2 & 4 weeks after the treatment. The data were analyzed using 2 test, Fisher's exact test, t-test, and repeated measures ANOVA. SPSS was used to aid analysis. RESULTS: 1) The experimental group showed higher levels of knowledge of smoking prevention compared to the control group. However this program did not affect their attitude towards smoking. 2) There was a higher possibility of smoking in the future among the students who had smoked than those who had not. 3) The majority (84.9%) of the experimental group said that the program was effective. CONCLUSION: Knowledge of smoking for the experimental group was increased, so it is assumed that the program itself had a positive effect on the students. To change attitudes regarding smoking, smoking prevention programs need to be conducted repeatedly, not just temporarily.

A Case of Abdominal Pregnancy / 대한산부인과학회잡지

An abdominal pregnancy is defined as an ectopic pregnancy, which implants in the peritoneal cavity and can be classified as either primary or secondary. The incidence of abdominal pregnancy is increased after IVF or GIFT, induced abortion, endometriosis, and intrauterine devices may also contribute to an increased incidence. Early diagnosis and appropriate surgical management, regardless of stage of gestation, appear to be important in achieving good results. A case of early primary abdominal pregnancy which was implanted on the left uterosacral ligament. We report the case and brief review of literature.

The Relationship between Bone Mineral Density and Serum Lipid Profile in Postmenopausal Women / 대한산부인과학회잡지

OBJECTIVE: To assess the correlation of serum lipid profile with lumbar bone mineral density (BMD) in postmenopausal women and investigate whether serum lipid profile could be a risk factor of osteoporosis. METHODS: From 1995 to 2003, we retrospectively reviewed 231 postmenopausal women, who did not take any drugs affecting lipid or bone metabolism. The hysterectomized women or metabolic disease patients were excluded. We analyzed the relationship between serum lipid profile and other parameters in normal and osteopenic groups based on lumbar BMD. RESULTS: There was no significant relationship between serum lipid profile and lumbar BMD in univariate analysis (chi-squared test and Pearson correlation analysis). Lumbar BMD was correlated inversely with age (r=-0.355, por=160 mg/dL) LDL-C levels were 1.09 (95%CI: 0.58-2.05) and 1.10 (95%CI: 0.44-2.79), respectively, compared to normal (<130 mg/dL) LDL-C group. CONCLUSION: There was no correlation between serum lipid profile and lumbar BMD. Serum lipid profile may not be a risk factor of osteoporosis, however, a prospective study in a larger group, considered with multiple factors, will be required to get more proper conclusions.

Effect of Pulsed Electromagnetic Fields in the Treatment of Knee Osteoarthritis. Report of Double-blind, Placebo-controlled, Randomized Trial / 대한류마티스학회지

OBJECTIVE: To determine the effectiveness of pulsed electromagnetic fields (PEMF) in the treatment of knee osteoarthritis (OA). MEHTODS: In this randomized, placebo-controlled, double-blind trial, 51 patients with knee OA, diagnosed according to the criteria of the American College of Rheumatology, were treated with PEMF or placebo. Eleven patients failed to attend after screening and were excluded from analysis. Treatment consisted of 3 half-hour periods of exposure per week over 6 weeks in a specially designed cylindrical device that emits low-frequency pulsed electromagnetic fields (25 gauss, 12 Hz). The primary outcome measure was reduction in pain on movement using a 10 cm visual analog scale. Secondary outcome measures included joint swelling and tenderness, the Lequesne index, and overall evaluations of improvement by the patient and examining physician. Evaluations were made at baseline, 3 week and 6 week during treatment and 4 weeks after finishing treatment. RESULTS: There were no significant differences between PEMF and placebo groups in respect of any outcome measures after treatment. Range of motion and knee swelling tended to be improved in the PEMF group. There were no clinically relevant adverse effects attributable to PEMF treatment. CONCLUSION: These results suggest that the PEMF treatment has no clinically significant benefits in patients with knee OA resistant to conventional treatment. The larger studies are needed to confirm the efficacy of PEMF therapy in knee OA.

Two Cases of Adenoma Malignum of the Uterine Cervix / 대한산부인과학회잡지

Adenoma malignum (minimal deviation adenocarcinoma) is a rare, well-differentiated form of cervical adenocarcinoma. This name is derived from the benign epithelial cell lining the glands. Despite its benign appearance, adenoma malignum have clinical malignant features. Because of its rarity and subtle histologic changes, it is quite difficult to diagnosis and may be missed. Adenoma malignum may carry a poor prognosis. We presented two cases of adenoma malignum of the uterine cervix with a brief review of related literatures.

Sjogren's Syndrome Presenting as Remitting Seronegative Symmetric Synovitis with Pitting Edema(RS3PE)

Remitting seronegative symmetric synovitis with pitting edema (RS3 PE) syndrome is characterized by symmetrical and acute synovitis, pitting edema, the absence of rheumatoid factor, increased acute phase reactants, lack of bony erosions on radiography, and benign and short clinical course. Half of all patients with Sjogren's syndrome experience arthritis during the disease course. We here describe the first case of Sjogren's syndrome presenting as RS3PE. She had swelling in knees, ankles, and wrists. After then the swelling spread to her lower legs, feet, face, and both hands. She was admitted to another hospital and was suspected of lupus or rheumatoid arthritis. Three months later, she had dry mouth and had lower lip biopsy. She was admitted to this hospital due to development of swelling in face and lower legs for 3 days. On physical examination, she had pitting edema in both hands and feet dorsum. Laboratory test showed elevated erythrocyte sedimentation rate, positivity of rheumatoid factor, anti-nuclear antibody, and anti-Ro antibody. There was no erosion in the hands radiography. Schirmer's test and lip biopsy was compatible with Sjogren's syndrome. She was diagnosed RS3 PE and Sjogren's syndrome. She was begun with prednisolone and her symptoms improved gradually.

The Clinical Significance of Oral Glucose Tolerance Test in Gestational Diabetes Mellitus / 대한산부인과학회잡지

OBJECTIVE: This study was performed to identify the clinical characteristics on the prevalence of gestational diabetes mellitus (GDM) related to risk factors and to assess the significance of screening test. METHODS: From Jan. 2000 to Dec. 2001, 513 women attending prenatal clinic were screened for GDM. Universal screening with 50 gm GTT were performed during 24-28th gestational weeks period. Women with 1 hour plasma glucose >or=140 mg/dl underwent 100 gm GTT for diagnosis of GDM. The patients were divided into high risk and control group. RESULTS: The overall incidence of GDM was 3.1%. Among high risk group and control group, the prevalence of positive screening tests were 28.9% vs 13.6% (P=0.001), and frequencies of abnormal 100 gm GTTs were 8.8% vs 0.6% (P=0.001), respectively. These rates were statistically significant. The significant risk factors were glucosuria, family history of DM and obesity (BMI >or=25). With increasing BMI, the prevalence of GDM was found to be significantly increased. CONCLUSION: The screening test of GDM would be preferable for all pregnant women rather than risk group only. Intensified management approach is needed for patients with glucosuria, family history of DM or obesity.