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Abstract Recessive variants of the SLC26A4 gene are an important cause of hereditary hearing impairment. Several transgenic mice with different Slc26a4 variants have been generated. However, none have recapitulated the auditory phenotypes in humans. Of the SLC26A4 variants identified thus far, the p.T721M variant is of interest, as it appears to confer a more severe pathogenicity than most of the other missense variants, but milder pathogenicity than non-sense and frameshift variants. Using a genotype-driven approach, we established a knock-in mouse model homozygous for p.T721M. To verify the pathogenicity of p.T721M, we generated mice with compound heterozygous variants by intercrossing Slc26a4 +/T721M mice with Slc26a4 919-2A>G/919-2A>G mice, which segregated the c.919-2A > G variant with abolished Slc26a4 function. We then performed serial audiological assessments, vestibular evaluations, and inner ear morphological studies. Surprisingly, both Slc26a4 T721M/T721M and Slc26a4 919-2A>G/T721M showed normal audiovestibular functions and inner ear morphology, indicating that p.T721M is non-pathogenic in mice and a single p.T721M allele is sufficient to maintain normal inner ear physiology. The evidence together with previous reports on mouse models with Slc26a4 p.C565Y and p.H723R variants, support our speculation that the absence of audiovestibular phenotypes in these mouse models could be attributed to different protein structures at the C-terminus of human and mouse pendrin.

Background: Giardia duodenalis is a zoonotic protozoan parasite causing diarrhea through waterborne or fecal-oral infection. The cysts can live in the drinking water and cause pandemic diseases. In Taiwan, very little information is available regarding the epidemiology of G. duodenalis in domestic animals. Methods: Fecal samples were collected from cattle (n = 156) and pigs (n = 141) in Hualien country, eastern Taiwan. Detection and genotyping were done by microscopy examination of fecal samples and amplification of the β-giardin gene using nested PCR. Results: The prevalence of G. duodenalis infection was 19.87% for cattle (31/156) and 4.26% for pigs (6/141). Using nested PCR, 30 infected samples found in cattle belonged to Assemblage E, and one sample belonged to Assemblage D. For pigs, four samples belonged to Assemblage E, one belonged to Assemblage D, and another one belonged to Assemblage A. In addition, these results showed that G. duodenalis Assemblage A was detected in pigs and may cause zoonotic transmission. Conclusion: This is the first epidemiological investigation of G. duodenalis infection in animals in Hualien, Taiwan. These results could provide epidemiological information for disease control and public health protection.

Abstract A single-blind study to investigate the effects of noisy galvanic vestibular stimulation (nGVS) in straight walking and 2 Hz head yaw walking for healthy and bilateral vestibular hypofunction (BVH) participants in light and dark conditions. The optimal stimulation intensity for each participant was determined by calculating standing stability on a force plate while randomly applying six graded nGVS intensities (0–1000 µA). The chest–pelvic (C/P) ratio and lateral deviation of the center of mass (COM) were measured by motion capture during straight and 2 Hz head yaw walking in light and dark conditions. Participants were blinded to nGVS served randomly and imperceivably. Ten BVH patients and 16 healthy participants completed all trials. In the light condition, the COM lateral deviation significantly decreased only in straight walking (p = 0.037) with nGVS for the BVH. In the dark condition, both healthy (p = 0.026) and BVH (p = 0.017) exhibited decreased lateral deviation during nGVS. The C/P ratio decreased significantly in BVH for 2 Hz head yaw walking with nGVS (p = 0.005) in light conditions. This study demonstrated that nGVS effectively reduced walking deviations, especially in visual deprived condition for the BVH. Applying nGVS with different head rotation frequencies and light exposure levels may accelerate the rehabilitation process for patients with BVH. Clinical Trial Registration This clinical trial was prospectively registered at www.clinicaltrials.gov with the Unique identifier: NCT03554941. Date of registration: (13/06/2018).

An ischemic stroke is brain damage caused by interruption of blood supply to the brain that can cause death and long-term disability. New medical strategies or therapies are urgently needed for ischemic stroke. Icaritin (ICT) is a metabolite of icariin (ICA), which are two active flavonoid components extracted from Herba epimedii and considered neuroprotective agents in animal models of Alzheimer’s disease and ischemic stroke. The therapeutic effect of ICT on ischemic still remains to be clarified. The aim of this study was to investigate the therapeutic effect of ICT on cerebral ischemia-reperfusion-associated senescence and apoptosis in a middle cerebral artery occlusion (MCAO) mouse model (ischemia for 50 min and reperfusion for 24 h). Administration of ICT after ischemia significantly reduced MCAO-induced neurological damage, infarct volume, and histopathological changes in the brain of acute ischemic stroke mice. ICT treatment could also reduce neuronal apoptosis and senescence and reversed the expression of apoptosis- and senescence-related signaling proteins. These findings suggest that ICT may have therapeutic potential to ameliorate acute ischemic stroke.

With diverse etiologies and clinical features, the management of pediatric auditory neuropathy spectrum disorder (ANSD) is often challenging, and the outcomes of cochlear implants (CIs) are variable. This study aimed to investigate CI outcomes in pediatric patients with ANSD of different etiologies. Thirty-six children with ANSD who underwent cochlear implantation between 2001 and 2021 were included. Comprehensive etiological analyses were conducted, including a history review, next-generation sequencing-based genetic examinations, and imaging studies using high-resolution computed tomography and magnetic resonance imaging. Serial behavioral and speech audiometry were performed before and after surgery, and the outcomes with CI were evaluated using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores. By etiology, 18, 1, 1, and 10 patients had OTOF-related, WFS1-related, OPA1-related, and cochlear nerve deficiency (CND)-related ANSD, respectively. Six patients had no definite etiology. The average CI-aided behavioral threshold was 28.3 ± 7.8 dBHL, and those with CND-related ANSD were significantly worse than OTOF-related ANSD. The patients’ median CAP and SIR scores were 6 and 4, respectively. Favorable CI outcomes were observed in patients with certain etiologies of ANSD, particularly those with OTOF (CAP/SIR scores 5–7/2–5), WFS1 (CAP/SIR score 6/5), and OPA1 variants (CAP/SIR score 7/5). Patients with CND had suboptimal CI outcomes (CAP/SIR scores 2–6/1–3). Identifying the etiologies in ANSD patients is crucial before surgery and can aid in predicting prognoses.

Stroke, which is the second leading cause of mortality in the world, is urgently needed to explore the medical strategies for ischemic stroke treatment. Both icariin (ICA) and icaritin (ICT) are the major active flavonoids extracted from Herba epimedii that have been regarded as the neuroprotective agents in disease models. In this study, we aimed to investigate and compare the neuroprotective effects of ICA and ICT in a middle cerebral artery occlusion (MCAO) mouse model. Male ICR mice were pretreated with both ICA and ICT, which ameliorated body weight loss, neurological injury, infarct volume, and pathological change in acute ischemic stroke mice. Furthermore, administration of both ICA and ICT could also protect against neuronal cell apoptotic death, oxidative and nitrosative stress, lipid peroxidation, and extracellular matrix (ECM) accumulation in the brains. The neuroprotective effects of ICT are slightly better than that of ICA in acute cerebral ischemic stroke mice. These results suggest that pretreatment with both ICA and ICT improves the neuronal cell apoptosis and responses of oxidative/nitrosative stress and counteracts the ECM accumulation in the brains of acute cerebral ischemic stroke mice. Both ICA and ICT treatment may serve as a useful therapeutic strategy for acute ischemic stroke.

Abstract Chondrosarcoma is a malignant primary bone tumor. Sirtuin-1 (SIRT1), which is a member of sirtuin family, plays a dual role either in cancer promotion or suppression. There is no report about the role of SIRT1 in the human chondrosarcoma cells. Resveratrol is a potent activator of SIRT1. However, its effects on chondrosarcoma have not been extensively studied. Here, we investigated the role of SIRT1 induction by resveratrol in human chondrosarcoma cell growth and tumor progression. Resveratrol significantly decreased cell viability and induced cell apoptosis in human chondrosarcoma cells in a dose-dependent manner. The protein expression and activity of SIRT1 were activated after treatment with resveratrol. Resveratrol significantly inhibited NF-κB signaling by deacetylating the p65 subunit of NF-κB complex, which could be reversed by siRNA-SIRT1 transfection or deacetylation inhibitor MS-275. Resveratrol induced-apoptosis involved a caspase-3-mediated mechanism. Both siRNA-SIRT1 transfection and MS-275 significantly inhibited the resveratrol-induced caspase-3 cleavage and activity in human chondrosarcoma cells. Moreover, in vivo chondrosarcoma xenograft study revealed a dramatic reduction in tumor volume and the increased SIRT1 and cleaved caspase-3 expressions in tumors by resveratrol treatment. These results suggest that resveratrol induces chondrosarcoma cell apoptosis via a SIRT1-activated NF-κB deacetylation and exhibits anti-chondrosarcoma activity in vivo.

Eruptive melanocytic nevi (EMN) is a rare phenomenon with an unclear pathogenesis. Mutation on a molecular basis has been proposed, but insufficient data are available to confirm this hypothesis. Theoretically, the possibility of malignant transformation is high, but no previous definite cases had been reported. Herein, we report the first case of a patient with EMN in whom hypopharyngeal low-grade melanocytic malignancies were detected using a fibrolaryngoscope. BRAF activation and p16 mutations were discovered through real-time polymerase chain reaction and immunohistochemical staining on EMN tissue samples, respectively. The significance of these findings has yet to be determined.

Objective: The purpose of the study is to report and to analyze the complications following intratympanic injections (ITI) of steroids. The occurrence rate of complications at different ITI sites, four quadrants of eardrum, was also compared. Methods: A retrospective clinical review in a medical center. Each patient received ITI twice in a week for 2â3 consecutive weeks as a salvage therapy for sudden sensorineural hearing loss. Post-injection complications, especially transient dizziness and vertigo, were recorded. Patients with acute or chronic vertigo episodes in 1 month were excluded. Results: A total of 59 patients with sudden sensorineural hearing loss and a total of 278 times of ITI were performed in 1 year. The post-injection complications included pain, tongue numbness, transient dizziness, vertigo, tinnitus, and a small persistent perforation. There was no significant difference in the occurrence of these complications between the injections sites on the 4 quadrants of the tympanic membrane. However, there was statistical significance in the post-injection vertiginous episode after IT injections to posterior-inferior quadrant (Q3) and posterior-superior quadrant (Q4) compared to anterior-superior quadrant (Q1) and anterior-inferior quadrant (Q2) (PÂ =Â 0.0113). Conclusion: IT injection is recommended to be applied to the Q2 since the Q1 and Q4 injections are more likely to induce the adverse effect of tongue numbness, while the Q3 and Q4 areas are more likely to induce post-injection vertigo. Keywords: Intratympanic injection, Sudden deafness, Complications, Vertigo

Benzo[a]pyrene, a ubiquitous environmental pollutant, has been suggested to be capable of initiating and/or accelerating atherosclerosis. Accumulation of vascular smooth muscle cells (VSMCs) in vessel intima is a hallmark of atherosclerosis. Nitric oxide (NO) can suppress VSMCs proliferation and induce VSMCs apoptosis. NO plays a compensatory role in the vascular lesions to reduce proliferation and/or accelerate apoptosis of VSMCs. The aim of this study was to investigate whether benzo[a]pyrene can affect VSMCs growth and apoptosis induced by NO. Benzo[a]pyrene (1-30 μmol/L) did not affect the cell number and cell cycle distribution in VSMCs under serum deprivation condition. Sodium nitroprusside (SNP), a NO donor, decreased cell viability and induced apoptosis in VSMCs. Benzo[a]pyrene significantly suppressed SNP-induced cell viability reduction and apoptosis. VSMCs cultured in conditioned medium from cells treated with benzo[a]pyrene could also prevent SNP-induced apoptosis. Benzo[a]pyrene was capable of inducing the activation of nuclear factor (NF)-κB and phosphorylation of p38 mitogen-activated protein kinase (MAPK) in VSMCs. Both NF-κB inhibitor and p38 MAPK inhibitor significantly reversed the anti-apoptotic effect of benzo[a]pyrene on SNP-treated VSMCs. Incubation of VSMCs with benzo[a]pyrene significantly and dose-dependently increased interleukin (IL)-6 production. A neutralizing antibody to IL-6 effectively reversed the anti-apoptotic effect of benzo[a]pyrene on SNP-treated VSMCs. Taken together, these results demonstrate for the first time that benzo[a]pyrene activates IL-6 induction and protects VSMCs from NO-induced apoptosis. These findings propose a new mechanism for the atherogenic effect of benzo[a]pyrene.

Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder that usually presents as cervical lymphadenopathy. Extranodal involvement occurs in up to 40% of patients. The disease is most prevalent in blacks and rare in Asians. This study analyzed the characteristics of RDD in patients from Taiwan. Methods: Fourteen patients with a diagnosis of RDD were identified by review of records from 1995 to 2004 at National Taiwan University Hospital. Tissue sections from each patient were reviewed and immunohistochemical staining was performed. Data on clinical presentations, associated diseases, treatment and outcome were analyzed. In situ hybridization for Epstein-Barr virus (EBV)-encoded small RNAs (EBER-1) was also performed. Sets of primers specific for the conservative region of bacterial 16S-rDNA, IS6110 of Mycobacterium tuberculosis complex and consensus region of human herpes virus (HHV) DNA polymerase genome were used to detect the presence of these infectious agents in the specimens. Results: There were six men and eight women with a mean age of onset of 44 years. Nine patients presented with skin lesions, four with lymph node involvement and one with nasal tumor. All lesions followed a chronic and indolent course. Most of the lesions regressed spontaneously, and no patients died as a result of this disease during follow-up. Three patients had associated immune-mediated disease, i.e. hemolytic anemia, ankylosing spondylitis and asthma. Two patients had a history of tuberculosis. Histologically, all lesions were characterized by a mixed infiltrate of large pale histiocytes, abundant plasma cells and lymphocytes regardless of the site of involvement. The strong immunoreactivities of these histiocytes to S-100 protein, CD68 and CD14 with occasional lymphophagocytosis were helpful in confirming the diagnosis, polymerase chain reaction analysis of 16S-rDNA, IS6110 and HHV gene and in situ hybridization for EBV were all negative. Conclusion: RDD in Taiwan is characterized by older age of onset compared to Western countries (44 years vs. 20 years) and more frequent extranodal involvement. The skin was the most common site of extranodal involvement, with about two-thirds of patients presenting with cutaneous lesions. There was no evidence of bacterial, mycobacterial or HHV infection in this series.

Mutations in the SLC26A4 gene are a common cause of human hereditary hearing impairment worldwide. Previous studies have demonstrated that different SLC26A4 mutations have different pathogenetic mechanisms. By using a genotype-driven approach, we established a knock-in mouse model (i.e., Slc26a4(tm2Dontuh/tm2Dontuh) mice) homozygous for the common p.H723R mutation in the East Asian population. To verify the pathogenicity of the p.H723R allele in mice, we further generated mice with compound heterozygous mutations (i.e., Slc26a4(tm1Dontuh/tm2Dontuh) ) by intercrossing Slc26a4(+/tm2Dontuh) mice with Slc26a4(tm1Dontuh/tm1Dontuh) mice, which segregated the c.919-2A>G mutation with an abolished Slc26a4 function. Mice were then subjected to audiologic assessments, a battery of vestibular evaluations, inner ear morphological studies, and noise exposure experiments. The results were unexpected; both Slc26a4(tm2Dontuh/tm2Dontuh) and Slc26a4(tm1Dontuh/tm2Dontuh) mice showed normal audiovestibular phenotypes and inner ear morphology, and they did not show significantly higher shifts in hearing thresholds after noise exposure than the wild-type mice. The results indicated not only the p.H723R allele was non-pathogenic in mice, but also a single p.H723R allele was sufficient to maintain normal inner ear physiology in heterozygous compound mice. There might be discrepancies in the pathogenicity of specific SLC26A4 mutations in humans and mice; therefore, precautions should be taken when extrapolating the results of animal studies to humans.

Recessive mutations in the SLC26A4 gene are a common cause of hereditary hearing impairment worldwide. Previous studies have demonstrated that different SLC26A4 mutations may have different pathogenetic mechanisms. In the present study, we established a knock-in mouse model (i.e., Slc26a4(tm1Dontuh/tm1Dontuh) mice) homozygous for the c.919-2A>G mutation, which is a common mutation in East Asians. Mice were then subjected to audiologic assessment, a battery of vestibular evaluations, and inner ear morphological studies. All Slc26a4(tm1Dontuh/tm1Dontuh) mice revealed profound hearing loss, whereas 46% mice demonstrated pronounced head tilting and circling behaviors. There was a significant difference in the vestibular performance between wild-type and Slc26a4(tm1Dontuh/tm1Dontuh) mice, especially those exhibiting circling behavior. Inner ear morphological examination of Slc26a4(tm1Dontuh/tm1Dontuh) mice revealed an enlarged endolymphatic duct, vestibular aqueduct and sac, atrophy of stria vascularis, deformity of otoconia in the vestibular organs, consistent degeneration of cochlear hair cells, and variable degeneration of vestibular hair cells. Audiologic and inner ear morphological features of Slc26a4(tm1Dontuh/tm1Dontuh) mice were reminiscent of those observed in humans. These features were also similar to those previously reported in both knock-out Slc26a4(-/-) mice and Slc26a4(loop/loop) mice with the Slc26a4 p.S408F mutation, albeit the severity of vestibular hair cell degeneration appeared different among the three mouse strains.

BACKGROUND Nail braces are an alternative treatment for ingrown toenails. OBJECTIVE This study aimed to prospectively examine the efficacy of nail braces for treatment of acute inflamed (AI)-type and chronic dystrophic-type ingrown toenails. MATERIALS AND METHODS The authors conducted a prospective study of patients with ingrown toenails treated at Wan Fang Hospital between January 1, 2017, and July 31, 2018. Evaluation using physician global assessment scores and patient satisfaction questionnaires was performed at 1, 3, and 6 months after the start of treatment and during the final visit. Patient demographics, treatment courses, and outcomes were compared between the 2 types of ingrown toenails. RESULTS Chronic dystrophic-type and AI-type ingrown toenails were observed in 25 (61 sides) and 28 patients (35 sides), respectively. Of the affected sides, 80.9%, 94.9%, and 100% achieved an excellent or fair result at 1, 3, and 6 months, respectively. Treatment duration and follow-up period were 179.2 6 96.8 days and 281.6 6 120.9, respectively. The recurrence rate was 7.4%. The treatment course and response were different between the 2 types of ingrown toenails. CONCLUSION Ingrown toenails could be effectively treated with nail braces with excellent outcomes, favorable patient satisfaction, and low recurrence rates. [ABSTRACT FROM AUTHOR]

Introduction: Some viral warts are refractory to treatment, some others tend to recur. Oral isotretinoin is useful against warts to varying degrees. Objective: To determine the efficacy of oral isotretinoin for treating mucocutaneous human papillomavirus infections. Methods: A systematic review and meta‑analysis of studies published from the date of inception of the databases to December 30, 2017 were conducted. Randomized controlled trials or case series with ≥10 patients with mucocutaneous human papillomavirus infection who had received oral isotretinoin treatment were analyzed. The meta‑analysis estimated the pooled odds ratio and pooled response rate. Results: The review included eight studies. Trials of oral isotretinoin versus placebo treatment revealed that isotretinoin effectively treated mucocutaneous human papillomavirus infections (odds ratio: 43.8, 95% confidence interval: 9.7–198.8). The pooled estimate of the complete response rate of oral isotretinoin to mucocutaneous human papillomavirus was 67.7% (95% confidence interval: 49.5–81.7%). Another pooled estimation revealed that 83.9% (95% confidence interval: 59.7–94.9%) of patients exhibited at least 50% lesion clearance, whereas 12.3% with complete response experienced recurrence. Limitations: This meta‑analysis had a small sample size and high inter‑study heterogeneity. Conclusion: Oral isotretinoin is superior to placebo for treating mucocutaneous human papillomavirus infections, particularly plane warts. The recurrence rate and risk of severe side effects are low. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: This study used air-conducted sound (ACS) and bone-conducted vibration (BCV) stimuli in eliciting ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) in guinea pigs. Study Design: Prospective study. Methods: Ten guinea pigs were treated with gentamicin (4 mg) on the left ear, whereas the right ear served as a control. One week after treatment, each animal underwent oVEMP and cVEMP tests using ACS and BCV modes in a randomized order, and was sacrificed for morphological study. Results: Using ACS mode, oVEMPs were absent in all 10 (100%) animals despite the stimulus intensity increased up to 120 dB pe SPL. Conversely, using BCV mode, oVEMPs were present on the left (lesion) eye, and absent on the right (control) eye in all (100%) animals. For the cVEMPs via ACS mode, all right (control) necks had clear cVEMPs, and all (100%) left (lesion) necks revealed absent cVEMPs. However, via BCV mode, all right (control) necks and six (60%) left (lesion) necks showed clear cVEMPs. Morphological study demonstrated substantial loss of hair cells in the utricular and saccular macula. Conclusions: The cVEMP test via ACS mode is specific for investigating the saccular disorder, whereas the oVEMP test via BCV mode is preferable for investigating the utricular disorders in humans. The guinea pig model is consistent with the findings of humans. Restated, appropriate animal models for cVEMP and oVEMP in guinea pigs are via ACS and BCV modes, respectively. Laryngoscope, 2010 [ABSTRACT FROM AUTHOR]

This study aimed to establish an animal model of ocular vestibular-evoked myogenic potential (oVEMP) in guinea pigs. Ten healthy and 10 gentamicin-treated guinea pigs underwent oVEMP test using a hand-held bone-conducted vibrator placed on the animal’s forehead. All 10 healthy animals exhibited bilateral oVEMPs at the stimulus intensity of 139 dB force level (FL), with a mean threshold and latencies of peak nI and pI of 130 ± 4 dBFL, 3.17 ± 0.37 ms and 4.72 ± 0.38 ms, respectively. Similar to response rate, the nI–pI amplitude decreased markedly in magnitude as stimulus intensity decreased. Another 10 animals administered with gentamicin (2 mg) on the left ear 1 week after surgery had 100% clear oVEMPs beneath the left eye (ipsilateral to the lesion side), whereas oVEMPs were absent and reduced beneath the right eye (opposite to the lesion side) in 7 and 3 animals, respectively. Morphological study of animals with absent oVEMPs identified substantial damage to the hair cells of the utricular macula. Quantitative analysis revealed that histological density of intact hair cells of the utricular macula from control and lesion ears were 194 ± 15 and 66 ± 9 per 130 × 130 μm2 field, respectively, showing a 68% reduction in the latter. Further, the stereocilia of the residual hair cells were either fused or deformed, and pointed outward randomly. In conclusion, this study establishes the animal model of oVEMP in guinea pigs using bone-conducted vibration stimuli, which sets the stage for investigating the pathophysiology of the utricular disorders. [ABSTRACT FROM AUTHOR]

Objective/Hypothesis: Although most studies have identified damage in the cochlea and semicircular canals as the primary sites of aminoglycoside toxicity, little attention has been devoted to the toxic effects on the otolithic organs. This study aimed to assess the toxic effect of gentamicin eardrops on the inner ear end organs via a novel inner ear monitoring system combined with morphological examination. Study Design: Prospective study. Methods: Guinea pigs were treated with 50 μL saline (n = 10) and 50 μL gentamicin (40 mg/mL; n = 10) on the right and left round window membranes, respectively. An inner ear monitoring system, including auditory brainstem response (ABR), caloric, ocular vestibular-evoked myogenic potential (oVEMP), and cervical VEMP (cVEMP) tests, was used to assess ototoxicity in guinea pigs at 2 weeks after treatment. The animals were then sacrificed for morphological study via confocal microscopy. Results: Normal results in ABR, caloric, cVEMP, and oVEMP tests were shown in all saline-treated ears, whereas elevated ABR threshold and absent responses in caloric, oVEMP, and cVEMP tests were noted in all gentamicin-treated ears. The cochlear and vestibular explants harvested from the gentamicin-treated ears revealed substantial loss of hair cells. Conclusions: The inner ear monitoring system, including ABR, caloric, oVEMP, and cVEMP tests, might help to evaluate toxicity information of the topical eardrops or agents on the inner ear end organs, including cochlea, semicircular canals, utricle, and saccule. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to apply videonystagmography (VNG) and vestibular evoked myogenic potential (VEMP) tests to patients with Meniere attacks, to explore the mechanics of where saccular disorders may affect the semicircular canals. Methods: From January 2001 to December 2003. 12 consecutive patients with unilateral definite Meniere's disease with vertiginous attacks underwent VNG for recording spontaneous nystagmus, as well as VEMP tests. Results: At the very beginning of the Meniere attack, the spontaneous nystagmus beat toward the lesion side in 5 patients (42%) and toward the healthy side in 7 patients (58%). Twenty-four hours later, only 6 patients (50%) showed spontaneous nystagmus beating toward the healthy side. Nevertheless, spontaneous nystagmus subsided in all patients within 48 hours. The VEMP test was performed within 24 hours of a Meniere attack; the VEMPs were normal in 4 patients and abnormal in 8 patients (67%). After 48 hours, 4 patients with initially abnormal VEMPs had resolution and return to normal VEMPs, and the other 4 patients still had absent VEMPs. Conclusions: Most patients (67%) with Meniere attacks revealed abnormal VEMPs, indicating that the saccule participates in a Meniere attack. This is an important idea that stimulates consideration of the mechanism of Meniere attacks. [ABSTRACT FROM AUTHOR]

Objective-Steroid hormones, and particularly mineralocorticoids, are candidates for controlling the homeostasis of endolymph as steroid receptors are widely expressed in the cochlea. In contrast, experiments on adrenalectomized animals have shown that an absence of steroids had little effect on the ionic composition of endolymph and hearing ability. We thus hypothesized that local production of steroids in the inner ear may regulate cochlear fluid exchanges. Results-Using reverse transcription-polymerase chain reaction techniques, we showed that transcripts encoding the P450 side-chain cleavage, the 3β hydroxysteroid dehydrogenase (3β HSD) and the 17α hydroxylase (P450 C17) were expressed in the lateral wall, organ of Corti and modiolus. The mRNA encoding aldosterone synthase was expressed in the modiolus and lateral wall while the P450 11β1 hydroxylase was not detected at all in any of these tissues. In situ hybridization experiments on cochlear sections confirmed that the 3β HSD transcripts were expressed in the spiral ligament and modiolus and possibly in the hair cells of the organ of Corti. However, it was not possible to detect P450 C17 transcripts. Immunohistochemistry performed with an antibody raised against the various 3β HSD isoforms confirmed the localization found using in situ hybridization. Conclusions-These results suggest that enzymes of the steroid pathway leading to mineralocorticoids and sex steroid hormones, but not glucocorticoids, may be expressed in the rat cochlea. This work is in line with the recent description of local production of steroid hormones in the brain (neurosteroids), heart and skin. In the cochlea, the local production of mineralo and sex steroids could account for a paracrine role and could induce specific gene expression through steroid receptors or act via a non-genomic mechanism on membrane receptors or ionic exchangers. Experiments aimed at demonstrating enzymatic activities within... [ABSTRACT FROM AUTHOR]

Necrotizing external otitis is a potentially life-threatening infection involving the temporal and adjacent bones. The most frequent pathogen is attributed to Pseudomonas aeruginosa, but is rarely caused by Klebsiella pneumoniae. Recently, we encountered a 47-year-old diabetic man with a swollen obliterated external ear canal with granulation tissue on the right ear. Image study demonstrated skull base osteomyelitis, epidural abscess and cerebral venous sinus thrombi. It was later proved to be necrotizing external otitis caused by Klebsiella pneumoniae. He then underwent craniotomy for drainage of the epidural abscess, followed by intravenous ciprofloxacin and metronidazole for 2 consecutive weeks until both pus and blood cultures depicted no growth of pathogens. Based on this case, synergistic antibiotic therapy using a third-generation cephalosporin or quinolone (ciprofloxacin), accompanied by metronidazole, and even a short-term aminoglycoside is recommended for the treatment of severe Klebsiella-induced necrotizing external otitis. Surgical intervention should be limited without shedding of the pathogens. [ABSTRACT FROM AUTHOR]

An abstract of the article "Head and Neck Cancer photodynamic therapy suppresses the migration and invasion of head and neck cancer cells in vitro," by Ting-Hua Yang and colleagues is presented.