The objective of this study was to investigate the clinical features of tinnitus in patients with chronic otitis media (COM) and to evaluate changes in tinnitus following middle ear surgery in relation to audiologic outcome. Medical records were reviewed for 117 patients with COM who underwent middle ear surgery between March 2009 and March 2010. Of them, 44 patients who pre-operatively reported tinnitus on a tinnitus questionnaire and 28 patients who completed a tinnitus questionnaire 8 weeks after surgery were evaluated to determine the clinical characteristics of tinnitus in patients with COM and any change in tinnitus following middle ear surgery, respectively. New tinnitus symptoms that developed after surgery were also evaluated in previously asymptomatic patients. The pre-operative incidence of tinnitus in patients with COM was 43% (50/117), with 87% of these patients displaying sensorineural tinnitus. After middle ear surgery, tinnitus handicap inventory scores were reduced in 82% of patients (23/28). Mean values of loudness, annoyance, effect on life, and awareness of tinnitus were also significantly reduced. One patient displayed newly developed tinnitus after surgery. Analysis of the relationship between improvement in tinnitus and audiologic outcome demonstrated that the group of patients whose tinnitus handicap inventory was reduced by more than 10 showed significantly greater improvements in mean air-conduction thresholds than did patients in the other group. In conclusion, following middle ear surgery, most patients experienced a reduction in tinnitus and restored hearing, with surgery perceived as an important contributory factor.

BACKGROUND/OBJECTIVESDespite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake.SUBJECTS/METHODSA total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before 131I administration.RESULTSThe median iodine intake was 290 µg/day on the usual diet and 63.2 µg/day on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake.CONCLUSIONIodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.

Serum calcium and phosphorus levels are significantly associated with NAFLD. Further investigation is needed to verify whether calcium and phosphorus levels indicate a higher risk of NAFLD.

Gastric metastases from lung adenocarcinoma are rare. Because gastric metastasis grossly resembles advanced gastric cancer, it is difficult to diagnose gastric metastasis especially when the histology of the primary lung cancer is adenocarcinoma. We describe a case of gastric metastasis from primary lung adenocarcinoma mimicking Borrmann type IV primary gastric cancer. A 68-year-old man with known lung adenocarcinoma with multiple bone metastases had been experiencing progressive epigastric pain and dyspepsia over one year. Esophagogastroduodenoscopy revealed linitis plastica-like lesions in the fundus of the stomach. Pathologic examination revealed a moderately differentiated adenocarcinoma with submucosal infiltration. Positive immunohistochemical staining for thyroid transcription factor-1 (TTF-1) and napsin A (Nap-A) confirmed that the metastasis was pulmonary in origin. The patient had been treated with palliative chemotherapy for the lung cancer and had lived for over fifteen months after the diagnosis of gastric metastasis. Clinicians should be aware of the possibility of gastric metastasis in patients with primary lung adenocarcinoma, and additional immunohistochemical staining for Nap-A as well as TTF-1 may help in differentiating its origin.