This study was performed to evaluate the effects on hearing of video tape manufacturing workers exposed to organic solvents. The experimental groups included solvents exposed group 51 and unexposed group 57 workers. All workers was examined air and bone conduction sensitivity by pure tone audiometer. The mean age of solvents exposed group was 34.1 and nonexposed group was 35.8. The mean duration of solvents exposed group was 7.3years. High frequency hearing loss prevalence of both groups was 23.5% in the group exposed to organic solvents and 17.5% in nonexposed group. There is no statistical significants in the prevalence of high frequency hearing loss. According to comparison of mean auditory threshold value by frequencies, on the air conduction test, right was statistically significant in the 250, 500, 1000, 2000, 4000Hz, except 8000Hz. Left 250, 500, 1000Hz was statistically significant. On the bone conduction test, left 250, both 500, 1000, 2000, 4000Hz, except right 250Hz, was statistically significant difference. Generally, auditory sensitivity threshold of the exposed group was higher than the nonexposed group.
The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Objective : The authors conducted a retrospective study to evaluate the preservation rates of serviceable hearing and to determine its prognostic factors after gamma knife stereotactic radiosurgery[GK SRS] in the patient with vestibular schwannomas. Methods : Between December 1997 and March 2005, 54 patients with a sporadic vestibular schwannoma and serviceable hearing [Gardner Robertson grade I-II] were enrolled in this study. Electronic database of medical records and radiological examinations before and after GK SRS were investigated to the last follow up. The mean marginal dose was $12.3{\pm}0.7Gy$. The mean maximum dose delivered to the tumor center was 24.7Gy [$22{\sim}30Gy$]. The median tumor volume was 2cc [$0.1{\sim}9.1cc$]. The median follow-up period of magnetic resonance[MR] imaging was 31 months [$6{\sim}99\;months$], and the mean follow-up period of audiometry was 24 months [$4{\sim}70\;months$]. Results : The tumor control rate was 100% in the patients with the follow up period more than 2 years. The trigeminal and facial nerve preservation rates were 98% and 100%, respectively. Twenty-eight [52%] of the 54 patients preserved serviceable hearing and 16 [30%] patients retained their pre-GK G-R grade level after GK SRS. In the univariate and multivariate analysis, there was no significant prognostic factor in preservation of the serviceable hearing. Conclusion : The hearing preservation rate is still unsatisfactory compared with the results of other cranial nerve preservation and tumor control in the treatment of vestibular schwannoma by GK SRS. More sophisticated strategy during and after GK SRS is necessary to improve long-term hearing preservation.
Purpose: A growing number of studies have been providing evidence for neural connections between the auditory and somatosensory systems that might be a critical part of the mechanisms underlying certain forms of tinnitus. The aim of this study was to investigate the effect of temporomandibular joint (TMJ) movements on tinnitus. Methods: One hundred sixty-three tinnitus patients participated in this study. All patients underwent a thorough audiological examination including pure-tone audiometry, tinnitus handicap inventory, and evaluation of tinnitus loudness, frequency and severity on a visual analog scale. Somatic testing consisting of nine forceful jaw muscle contractions was performed to evaluate the effect of TMJ movements on modulation of tinnitus. Results: 66.9% of patients had unilateral tinnitus. Somatic testing modulated tinnitus loudness in 125 ears (57.6 %) of 217 ears tested. An increase in tinnitus loudness was observed more often than a decrease. Loudness was most commonly increased by opening and clenching jaw. Tinnitus could be induced by opening, clenching and deviating jaw to the left. Conclusion: Our study showed evidence that TMJ movements may aggravate and even evoke tinnitus and somatic testing can be used for evaluating if stimulation of the TMJ induces or aggravates tinnitus.
Microvascular surgery has been widely used clinically for over 30 years. Although many types of free skin and myocutaneous flap are being used at present, surgeons are still looking for new flaps to suit the specific requirements of different recipient sites, to reduce the deformity at the donor site, to ease the management of the flap and to increase the success rate of those operations. The lateral thigh free flap was designed and reported simultaneously with the medial thigh free flap by Baek in 1983. The flap, based on the third perforator of the profunda femoris artery. is designed on the posterolateral aspect of the distal thigh. Clinically, the vascular variations and the locations of perforators of this system can be determined preoperatively with simple angiograms and Dopper audiometry. The lateral thigh free flap is suitable for reconstruction of defects in an oral floor with tongue and esophageal deficits, scalp defects with dural defects, and large full thickness defects of the lip. The advantages of this flap are safe elevation, a long vascular pedicles with a large lumen, skin that is generally thin, and good pliability. Furthermore, the skin territory is very wide and long. The donor site is hidden and therefore more acceptable to the patient. The disadvantage of this flap is that the anatomy of the pedicle vessels has irregular derivation from the main vessel. We had reconstructed lateral thigh free flap to the nine patients from January, 1997 to July, 1998 and got satisfactory results. In this paper we illustrate the arterial anatomy of the thigh and usefulness of this flap for the reconstruction of the head and neck.
Kim, Wook-Tae;Kim, Dae-Hwan;Lee, Chae-Kwan;Ahn, Jin-Hong;Lee, Chang-Hee;Kim, Hwi-Dong;Kim, Jeong-Ho;Son, Byung-Chul;Lee, Jong-Tae
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.17
no.2
/
pp.153-159
/
2007
Usually equal noise exposure is considered to cause symmetrical hearing loss, but some screening audiometries of employees who were exposed to noise showed asymmetry. Therefore, this study was carried out to evaluate the distribution of asymmetrical hearing loss and the difference of air conduction level between left and right ear at the different frequencies (500, 1,000, 2,000, 3,000, 4,000, 6,000 Hz). Study subjects were 326 male employees who had participated in the noise-specific health examination from May to October, 2002. They were evaluated by otoscopic examination, pure tone audiometry and tympanometry. In all frequencies, hearing threshold level of left ear was worse than right ear. The mean interaural threshold differences between two ears were 0.83 dB at 500 Hz, 1.18 dB at 2,000 Hz, 2.29 dB at 3,000 Hz, 2.18 dB at 4,000 Hz, and statistically significant (p<0.05). The hearing loss of left ear was greater than right ear in occupationally noise-exposed workers. It is believed that left ear was more susceptible to noise damage than right ear
Kim, Yi-Seul;Kang, Ji-Man;Lee, Ji-Hoon;Chang, Yoon Sil;Park, Won Soon;Kim, Yae-Jean
Pediatric Infection and Vaccine
/
v.24
no.1
/
pp.65-70
/
2017
Cytomegalovirus (CMV) infection is one of the most common congenital infections. The first case of discordant congenital CMV infection in twins occurred in Korea. A 31-year-old woman became pregnant with twins (dichorionic-diamniotic). An elective caesarean section was performed at 37 weeks. The first baby was male, weighing 2,410 g with an Apgar score of 8/9. The second baby was female, weighing 1,380 g with an Apgar score of 5/8. She had experienced intrauterine growth retardation, and presented with microcephaly, micrognathia, and joint stiffness. During the work-up for discordant twins, the second baby's serum test was positive for CMV immunoglobulin M. Her urine, blood, and cerebrospinal fluid (CSF) were CMV polymerase chain reaction positive. The first baby's CMV tests were negative. Ophthalmologic exam and audiometry performed on the second baby showed CMV retinitis and bilateral sensorineural hearing loss. She was treated with intravenous ganciclovir. Currently, she is bed-ridden and has significant developmental delay. Although the causes of discordant congenital CMV infection in twins are unclear, this case shows that discordant congenital CMV infection should be considered in twins with significant differences in intrauterine growth or clinical symptoms after birth.
To assess the hearing conservation by the hearing protection devices in the field, 1,237 healthy female weavers of 16 to 24 year old were surveyed from April 1982 to January 1983. By reviewing the charts, their working durations, hearing threshold shift levels and whether wearing the ear plugs or not were checked. The hearing threshold levels were measured at 4,000Hz by audiometry AA-30A, RION Japan. They were divided into two groups: an experimental group with ear plug and the control group without it. The threshold shift level above 40dB in controls was 44.6% in left and 40.9% in right ear and that in experimental group 8.0% in left and 6.6% in right ear. The distribution of threshold shift levels between control and experimental group was significantly different in both ears, but that between left and right ear not significantly different in both groups. The longer the working durations were, the more the proportion of high threshold shift levels was and the larger the differences in the proportion of above 40dB between both groups were.
Lee, Ju Eun;Kim, Ho Soon;Shin, Wan Gyoon;Cho, Nam Chun
Korean Journal of Clinical Pharmacy
/
v.8
no.2
/
pp.83-88
/
1998
Improved knowledge of the time course of antimicrobial activity should provide useful information for designing optimal dosage regimen. In contrast to $\beta$-lactam, aminoglycosides tend to induce a prolonged postantibiotic effect against aerobic or facultative gram negative rods and clinical outcome was significantly correlated with achieving peak serum concentrations. The objective of this study was to compare the efficacy, safety of e same total daily dose of amikacin and gentamicin given either twice or thrice daily in the treatment of patients. Consecutive patients over 20 years old with a suspected or confirmed infection for which an aminoglycosides was indicated were eligible. Exclusion criteria were known allergy to aminoglycosides, renal impairment, granulocytopenia and pregnancy. Patients were treated with intravenous amikacin 15 mg/kg/day or gentamicin 4.5 mg/kg/day either in two devided or in three devided. Seventy-four patients with infection were enrolled in this study of amikacin twice daily (A2, n=29), gentamicin twice daily (G2, n=8) vs amikacin thrice daily (A3, n=30), gentamicin thrice daily (G3, n=7). Baseline characteristics were comparable in G2 and G3. The clinical cure rate (including partial improve) were $89.0\%\;and\;86.0\%$ in A2 group and A3 group respectively. The bacteriologic cure rate were $99.0\%\;and\;85.7\%$ in A2 group and in A3 group respectively. The clinical and bacteriologic effects were difficult to compare G2 with G3, because of the small numbers of patients. The serum creatinin rose in $3.44\%$ (1 in 29) of patients in the A2 group compared to $13.3\%$ (4 in 30) in e A3 group. Although audiometry was not performed, there was no clinical evidence of ototoxicity in any of the patients. In our opinion, twice-daily regimen of aminoglycosides is more effective and less nephrotoxic than thrice-daily regimen.
In normal auditory systems, the difference between the bone conduction thresholds obtained with the test ear opened and occluded in low frequency signals below 1, 000Hz is about 10~25 dB. But no difference in these thresholds suggests the presence of a lesion in the conductive mechanism. Sullivan added the differences in these thresholds at 250Hz, 500Hz and 1,000Hz and called "Occlusion Index". In oder to study the audiological significance, we have measured the occlusion index in 40 ears of normal persons, 20 ears of chronic otitis media patients and 20 ears of sensori-neural hearing impairment patients. We also measured the static compliance in 40 normal ears and observed the correlation with the occlusion index. The results are as follows: 1. Occlusion index was 33. $10\pm10.63dB$ in normal group, $3.10\pm3.03dB$ in chronic otitis media; group, $28.10\pm15.17dB$ in sensori-neural group. 2. Static compliance in normal group was $0.61\pm0.31cc$ (0.22~1.75cc) 3. Occlusion index showed inverse proportion to static compliance.
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