• BMB Reports
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• v.32 no.1
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• pp.25-27
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• 1999

Otitis media with effusion (OME) is an inflammatory disease of the middle ear cleft. Oxygen free radicals have been implicated in a variety of inflammatory disorders. Oxygen free radicals may also be involved in the pathogenesis of OME. To evaluate the involvement of oxygen free radicals in the pathogenesis of OME, the level of malondialdehyde, which gives an index of lipid peroxidation by oxygen free radicals, was measured by the reaction with thiobarbituric acid. Malondialdehyde level in the middle ear fluid from the OME group was higher than that in the normal control group. Malondialdehyde level in the middle ear fluid from a mucoid subgroup was higher than that in the serous subgroup. Malondialdehyde levels in the middle ear fluid from the serous subgroup was significantly correlated with symptom duration. The Pearson correlation coefficient between malondialdehyde levels in the middle ear fluid from the serous subgroup and symptom duration was 0.842 (P<0.05). These results indicate that lipid peroxidation by oxygen free radicals may be involved in the pathogenesis of human OME.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.87-100
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• 2001

Otitis media with effusion(OME) is the second most common disease in childhood after upper respiratory tract infection. Antibiotic treatment and ventilation tube insertion are the common treatment. The emergence of drug-resistant streptococcus pneumoniae (DRSP) has implications for the primary care provider who treats acute otitis media(AOM) in children. OME need not be treated with antibiotics unless the effusion has been present for 3 to 4 months. Tympanostomy tubes are an effective treatment for both chronic OME and recurrent AOM. But the complications of tympanostomy tubes are serious Kamihyunggyeyungyotang is known to have antiinflmmatory and antiallergic effect. In this study, we investigated the clinical efficacy of the Kamihyunggyeyungyotang on recurrent otitis media with effusion prospectively by using pneumatoscopy, tympanogram, pure tone audiometry, and radiologic study. The patients who had treated by antibiotics was used as control. The statistical analysis was done by Mann-Whitney test and the significance was considered when the p value was less than 0.05. The general outcome was significantly higher in Kamihyunggyeyungyotang group than in antibiotic group. The recovery rate from grade 3 to 0 in pneumatoscopy was 42.5% but the control was 6%. Hearing gain was improved 71% and pnuematization was returned 70%.

• IMMUNE NETWORK
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• v.8 no.2
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• pp.59-65
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• 2008

Background: Toll-like receptors (TLRs) detect microbial infection and can directly induce innate host defense responses, which are thought to play critical roles in protecting the tubotympanum from infection. However, little is known about the relationship between TLRs, which are related to innate immunity, and immunoglobulins, which are related to adaptive immunity, in recurrent otitis media with effusion (OME). We therefore investigated the expression of TLR2 and TLR4 and immunoglobulin in children with OME. Methods: The study population consisted of 72 children with OME, 31 with more than 4 episodes in 12 months or more than 3 episodes in 6 months (otitis-prone group), and 41 with fewer than 3 episodes in 12 months (non-otitis prone group). The expression in middle ear effusion of TLR2 and TLR4 mRNA, as determined by Real time- -polymerase chain reaction (RT-PCR), and the concentrations of IgG, IgA, and IgM, as determined by Enzyme-linked immunosorbent assay(ELISA), were compared between the two groups. Results: Expression of TLR2 and TLR4 mRNA was lower in the otitis prone than in the non-otitis prone group, but the difference was not statistically significant (p>0.05). Between group differences in the concentrations of IgG, IgA and IgM in effusion fluid were not significant (p>0.05), and there were no correlations between immunoglobulin concentration and the expression of TLR2 and TLR4. Conclusion: Although there was a trend toward lower expression of TLR2 and TLR4 in the otitis-prone group, the differences, and those in immunoglobulin concentration, did not differ significantly between the otitis-prone and non-prone groups.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.3
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• pp.69-85
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• 2020

Objectives : The purpose of this study is to investigate the trend of Tranditional Chinese Medicine for Otitis Media with Effusion(OME) in Chinese journals. Methods : Chinese National Knowledge Infrastructure(CNKI) and Wanfang med online were used to search Chinese studies which were published from January, 2010 to April, 2020. Results : Among Chinese studies, Exterior-releasing medicinal(解表藥) and Heat-clearing medicinal(淸熱藥) were the most frequently used. The herbs which used the most frequently are Bupleuri Radix(柴胡), Acori Graminei Rhizoma(石菖蒲). All of studies have reported that Tranditional Chinese Medicine is effective for Otitis Media with Effusion. Conclusions : In analysis of selected studies, Tranditional Chinese Medicine is more effective than Western Medicine Treatments. Recurrence rates and side effects of OME can be reduced by cotreatment of Tranditional Chinese Medicine and Western Medicine Treatments.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.70-75
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• 2018

Background: Otitis media with effusion (OME) is defined as middle ear effusion without acute signs of infection. OME usually resolves spontaneously; however, persistent OME may require the insertion of a ventilation tube. This study investigated risk factors for persistent OME in children who undergo ventilation tube insertion. Methods: Children who were admitted to undergo ventilation tube insertion at Jeju National University Hospital between August 2015 and July 2016 were enrolled as the case group. Healthy children without persistent OME from August 2016 to July 2017 were enrolled as the control group. Baseline characteristics and predisposing factor data were collected using an interview questionnaire. Middle ear fluids were collected from the case group. Results: A total of 31 patients underwent ventilation tube insertion. The mean age of the case group was 4.53 years, with a male-to-female ratio of 21:10. Twenty-nine (93.5%) children attended a daycare center, and 21 (67.7%) had experience with bottle feeding. Fifteen (48.4%) children in the case group and 3 (9.7%) in the control group first attended a daycare center at <1 year of age (odds ratio=9.96; 95% confidence interval=2.44-39.70; p=0.001). No bacteria were found in middle ear fluid collected from the 31 operated children. Nasopharyngeal bacterial colonization was found in 13 (41.9%) and 17 (54.8%) children in the case and control groups, respectively. Conclusion: Earlier attendance at a daycare center was the only predisposing factor for ventilation tube insertion in our study. The aseptic nature of middle ear fluids found in children with OME highlights the efficacy of antimicrobial use.

• Korean Journal of Clinical Laboratory Science
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• v.39 no.1
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• pp.19-24
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• 2007

The aim of this study was to evaluate the bacterial effects of Moraxella catarrhalis in otitis media with effusion (OME) by photodynamic therapy (PDT). Bacterial suspensions (10000 CFU/mL) were prepared. The colony forming units (CFU) of Moraxella catarrhalis have been measured after an application of photogem plus 632 nm diode laser irradiation. One ml of the bacterial suspensions have been incubated in the dark for 3h with various concentrations of photogem ($0.625{\sim}5.0_{\mu}g/mL$) and then irradiated with 632 nm diode laser ($15J/cm^2$). After, the PDT Moraxella catarrhalis suspensions ($50{\mu}L$) were inoculated on chocolate agar plate and cultured in the dark at $37^{\circ}C$, 5% $CO_2$ condition for 18h. The colony forming units off the bacteria were measured. Also transmission electron microscopy (TEM) was employed to evaluate the effect of otitis media pathogens by PDT. The nucleus of Moraxella catarrhalis was stained using green fluorescent nucleic acid dye thiazole orange and the fluorescence intensity of the nucleus was measured by flow cytometry. The PDT was effective in killing Moraxella catarrhalis at the photogem dose of $5.0_{\mu}g/mL$, respectively, As assessed by flow cytometry analysis the fluorescence intensity of the nucleus got lower after PDT. TEM result appeared to able to cause damage to the bacterial membranes. On the basis of these findings, bacterial photodynamic therapy with photogem can be considered to be a promising new therapeutic approach for OME.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.2
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• pp.70-79
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• 2005

Background: Otitis media with effusion(OME) is one of the most common disease in childhood. Patient suffers from OME in many quarters. For example hearing loss, effects on speech, language, learning, behaviouralchanges etc. But the diagnosis of OME is difficult using only medical history and otoscopy. So, many other diagnostic tools are developed and tympanometry is one of them. When OME is treated by oriental medical Tx, tympanometry would be useful instrument. Objectives: To gain insight into the usability of tympanometry in F/U of OME treated by oriental medial Tx. Methods: Data was collected from 123 ears of 74 children who was treated by oriental medical Tx. Data includes sex, age, period of Tx, elapsed time to be improved, tympanograms and accompanied symptoms. The relationship between items was analysed by statistical methods. Results: There is no relationship between age, sex and period of Tx/elapsed time to be improved. When cough and phlegm is accompanied, the period of treatment and elapsed time to be improved are expanded. When improvement was seen on tympanogram, the period of treatment is expanded but the improvement was seen within 30days, the period of treatment is reduced. Conclusion: The application of tympanometry in oriental medical treatment of OME would provide us many informations about the status of patient so it will be helpful to predict the history of a case and to make a decision whether keep up treatment or not.

• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.106-112
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• 2015

Purpose: The long-term administration of antibiotics interferes with bacterial culture in the middle ear fluids (MEFs) of young children with otitis media with effusion (OME). The purpose of this study is to determine whether molecular diagnostics can be used for rapid and direct detection of the bacterial pathogen in culture-negative MEFs. Methods: The specificity and sensitivity of both polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) to the lytA gene of Streptococcus pneumoniae were comparatively tested and then applied for pneumococcal detection in the clinical MEFs. Results: The detection limit of the PCR assay was approximately $10^4$ colony forming units (CFU), whereas that of LAMP was less than 10 CFU for the detection of S. pneumoniae. Both PCR and LAMP did not amplify nucleic acid at over $10^6$ CFU of H. influenzae or M. catarrhalis, both of which were irrelevant bacterial species. Of 22 culture-negative MEFs from children with OME, LAMP positivity was found in twelve MEFs (54.5%, 12/22), only three of which were PCR-positive (25%, 3/12). Our results showed that the ability of LAMP to detect pneumococcal DNA is over four times higher than that of PCR (P<0.01). Conclusions: As a high-resolution tool able to detect nucleic acid levels equivalent to <10 CFU of S. pneumoniae in MEFs without any cross-reaction with other pathogens, lytA -specific LAMP may be applied for diagnosing pneumococcus infection in OME as well as evaluating the impact of a pneumococcal conjugate vaccine against OME.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.3
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• pp.84-94
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• 2005

Objective: In order to help clinical approach on OME patient in progress observation and decision on improvement by clinical research results using tympanometry. Methods: Data was collected from 163 ears of 96 patients who were treated in Dept. of Oriental Medical Ophthalmology & Otolaryngology & Dermatology, Kyung-Hee Medical Center from 2001-2-12 to 2005-4-29 for Otitis Media with Effusion(OME). Tympanometry was applied to all patients and the test result was used to evaluate progress and improvement. F/U cases below 3 times were excluded. Results & conclusion: 1. Age and sex distribution was as follows: Mean Age 5.5years old(Standard deviation: 2.1), age distribution 2-61years old, below 10years old 151cases(92.6%) and above 10years old 12cases(7.4%). Male and female ratio was 1.81:1. 2. There were 67people(69.8%) with bilateral affected ear. Unilateral was 29people(30.2%). Affected ear distribution according to sex came out similarly. 3. Affected period distribution was as follows: over 12weeks 71cases(43.6%), under 12weeks 92cases(56.4%). Out of under 12weeks cases, 2-4weeks was 34cases(20.9%), 0-1weeks and 5-8weeks 20cases(12.3%), 9-12weeks 18cases(11.0%). There was evident difference about affected period between male and female. 4. All patients who served previous Tx in medical clinic(118 cases) took antibiotics. Only 6cases took tube insertion. The period of Taking antibiotics was as fellows: over 6weeks 42cases(35.6%), under 5weeks 37cases(31.4%). unknown 25cases(21.2%), jntermittent 14cases(11.9%). 5. In Period of Tx distribution, 5-6weeks showed 40cases(24.5%) which was highest number. In Improved cases(85cases), 3-4weeks and 5-6weeks each 22cases(25.9%) which was highest number. 1-2weeks 3cases(3.5%), 7-8weeks 12cases(14.1%), 9-10weeks 9cases(10.6%), 11-12weeks 10cases(11.8%), over 12weeks 7cases(8.2%). 6. The cases which have gastrointestinal Sx were 71cases(43.6%), the others 92cases(56.4%). Details of gastrointestinal Sx were as follows: Sx associated with appetite 47cases(47.5%), constipation 15cases(15.2%), abdominal pain and diarrhea 14cases(14.1%), frequent vomitting Teases(7.1%), etc 4cases(4.0%). 7. The cases which have accompanying disease were 116case(71.2%), the other 47cases(28.8%). Details a accompanying disease were as follows: sinusitis 57cases(35%), rhinitis 55cases(3.7%), allergic rhinitis 20cases(12.3%), atopic dermatitis 19cases(1.7%), urticaria 4cases(2.5%), asthma 3cases(1.8%), nasal polyp and conjunctivitis 2cases(1.2%) each, laryngitis 1case(0.6%).