• The Korean Journal of Pain
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• 제13권2호
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• pp.191-195
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• 2000

Background: Vascular occlusive event is one of the etiologies of sudden sensorineural hearing loss (SNHL). Stellate ganglion block (SGB) induces dramatic and intense vasodilatation in head and neck. Based on this principle, SGB has used as one of the treatment modalities in SNHL. This study was performed to evaluate immediate response of SGB on pure tone audiogram (PTA) in SNHL. Methods: Forty patients were studied. Each patient received daily ipsilateral SGB in paratracheal approach using 0.2% bupivacaine for 2 weeks. On first, third, and fifth day of treatment, we checked their PTA twice 1 hour before (Pre-PTA) and after (Post-PTA) SGB. Pre- and Post-PTA were compared. Several factors were analyzed as a prognostic factor of therapeutic results. Results: Eleven of 40 patients revealed decreased PTA after SGB. Degree of decreased PTA were insignificant ($2.5{\pm}1.6$ dB). Initial and final PTA results was $76.2{\pm}22.5$ and $49.8{\pm}28.3$ dB, respectively. Thirty-one of 40 patients were improved their PTA over 10 dB. The recovery was mainly influenced by the severity of initial hearing loss (P<0.001) and slightly by age (P<0.05). However, the change of PTA after SGB, time interval to receive SGB, sex, site, and number of SGB were not correlated to therapeutic outcome. Conclusions: These results suggest that vasodilatation by SGB has no immediate improvement in SNHL. Therefore, we question whether SGB is beneficial to all patients with SNHL as a therapeutic modality.

• Clinical and Experimental Pediatrics
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• 제60권11호
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• pp.353-358
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• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• 대한의용생체공학회:의공학회지
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• 제19권1호
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• pp.59-68
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• 1998

디지털 보청기는 기존의 아날로그 보청기에 비하여 많은 장점이 있다. 디지털 신호처리 프로세서의 발달과 더불어 최근에 다양한 디지털 보청 알고리즘과 완전한 디지털 보청기가 선보였다. 디지털 보청기의 알고리즘을 개발하거나 디지털 보청기를 새로이 평가하려는 사람들에게 난청자를 대상으로 하는 임상연구는 필수적으로 거쳐야 하는 과정이다. 그러나 이러한 임상연구는 실제 난청자를 대상으로 하여야 하기 때문에 난청자와 검사자 간에 통상적으로 많은 시간과 노력이 필요하며 원활한 의사 소통이 때로는 어려울 수 있다. 왜냐하면 난청자들의 연령이 너무 어리거나 많아서 의사소통에 지장을 주거나 검사자가 필요로 하는 시간에 비슷한 난청 유형을 가진 대상자를 모으기 어렵다. 본고에서는 임상연구를 보조하여 디지털 보청기 또는 알고리즘이 개발되기까지 수행되어야 할 많은 임상연구의 결과를 예측하고 평가할 수 있는 디지털 난청 시뮬레이션 방법을 제안하고, 실제 환자의 데이터를 사용한 시뮬레이션과 그에 대한 임상 실험을 통하여 시스템의 성능을 평가하였다. 실험 결과, 정상인으로부터 모델링된 환자 데이터와 매우 유사한 측정 결과를 얻어냄으로써, 제안된 시스템이 목적하고자 하는 바를 이룰 수 있음을 검증하였다. 또한 난청 시뮬레이터의 목적인 디지털 보청기 알고리즘을 개발하기 위한 평가 툴로서, 개발 초기에 다양한 디지털 보청기용 알고리즘을 구현하여 실제 난청 시뮬레이터와 연계하여 실험함으로써 보청기 알고리즘의 평가 및 새로운 보청기 알고리즘을 개발하고 평가하거나 향후 난청자를 대상으로 하는 임상연구에서 사용할 수 있는 유용성을 입증하였다.로 우유 교육 프로그램이 향후보다 체계적이고 확대되어 지속적으로 실시된다면, 우유에 대한 의미는 물론 인식 그리고 지식 정도에 있어 효과적인 결과를 유도할 수 있을 것이다.니하였다. 6) Dibutyryl cyclic AMP 및 8-bromo cyclic GMP 모두 혈소판응집률(血小板凝集率)을 감소시켰고, 후자(後者)는 전자(前者)에 비(比)하여 월등(越等)히 현저(顯著)하였다. sodium nitroprusside에 의한 항응집률(抗凝集率)은 methylene blue 전처치(前處置)에 의하여 길항(拮抗)되었으나, bovine hemoglobin전처치에 의하여는 영향(影響)을 받지 아니하였다. 이상(以上)의 성적(成績)을 종합(綜合)하면, 뇌졸중증(腦卒中症)때, 특히 뇌혈전증(腦血栓症)의 응급치료시(應急治療時) sodium nitroprusside의 응용(應用)이 가능(可能)하다고 사료(思料)되며, 이에 대(對)하여 임상적(臨床的) 치료(治療)가 기대되는 바이다.다시 상승(上昇)하는 경향(傾向)이었다. 중성지질(中性脂質) 중(中) climacteric rise 및 숙도(熟度)와 관련하여 변화(變化)한 것은 diglyceride 및 sterol ester의 2종(種)이었으며 glyceride가 중성지질(中性脂質) 전량(全量)의 변화(變化)와 동일(同一)한 경향(傾向)인데 반(反)하여 sterol ester은 climactric onset까지 증가(增加)하다가 기후(其後) 감소(減少)하였다. 인지질(燐脂質)도 저장기간(貯藏期間) 중(中) 처리구(處理區)에 관계(關係)없이 다같이 감소(減少)되었는데, 그 정도(程度)

• 혜화의학회지
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• 제22권1호
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• pp.193-200
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• 2013

고막 스테로이드 주사 치료에 잘 반응하지 않는 돌발성 난청 환자에게 신허(腎虛)로 인한 허롱(虛聾)으로 판단하고 삼일신기환(三一腎氣丸) 가미방(加味方)을 투여하고 수소양삼초경(手少陽三焦經)의 이문(耳門), 예풍(翳風), 외관(外關), 수태양소장경(手太陽小腸經)의 청궁(聽宮), 족소양담경(足少陽膽經)의 청회(聽會),완골(完骨),양백(陽白),협계(俠谿)를 선혈(選穴)하여 침(鍼)치료를 하였고 한약제를 이용한 증기치료를 시행하여 이명, 이충만감 등의 동반 증상의 호전을 확인하였으며 청력검사 상 경미하게 호전된 상태를 확인하였다. 이는 본 질환에 대한 한방치료의 유효성을 보여주는 것으로 생각된다.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.63-66
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• 1997

With the advent of high speed digital signal processing chips, new digital techniques have been introduced to the hearing instrument. This advanced hearing instrument circuitry has led to the need or and the development of new fitting approach. A number of different fitting approaches have been developed over the past few years, yet there has been little agreement on which approach is the "best" or most appropriate to use. However, when we develop not only new hearing aid, but also its fitting method, the intensive subject-based clinical tests are necessarily accompanied. In this paper, we present an objective method to evaluate and predict the performance of hearing aids without the help of such subject-based tests. In the hearing impairment simulation (HIS) algorithm, a sensorineural hearing impairment model is established from auditory test data of the impaired subject being simulated. Also, in the hearing impairment simulation system the abnormal loudness relationships created by recruitment was transposed to the normal dynamic span of hearing. The nonlinear behavior of the loudness recruitment is defined using hearing loss unctions generated from the measurements. The recruitment simulation is validated by an experiment with two impaired listeners, who compared processed speech in the normal ear with unprocessed speech in the impaired ear. To assess the performance, the HIS algorithm was implemented in real-time using a floating-point DSP.

• 한방안이비인후피부과학회지
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• 제30권4호
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• pp.131-141
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• 2017

Objectives : The purpose of this study is to investigate recent clinical studies on the effect of acupuncture on hearing loss. Methods : Based on the PubMed search with the key search terms of 'hearing loss, acupuncture', dated from 2004 to 2017, 1 controlled trials, 3 case reports and 3 case series was found, and were analyzed for this study. Results : 1. The most commonly used acupoints were Shuaigu(GB8) and Fengchi(GB20). 2. The most commonly used meridians were the du channel, the gall bladder meridian of foot-shaoyang, and the triple bunner meridian of hand shaoyang. 3. Acupuncture treatment was effective for conductive and sensorineural hearing loss, especially sudden sensory neural hearing loss. 4. More clinical studies are needed to prove the effectiveness of the acupuncture on hearing loss. To be more objective on the study results, we can measure auditory brainstem response for hearing loss after acupuncture treatment.

• 대한임상검사과학회지
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• 제38권3호
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• pp.218-223
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• 2006

Sensorineural hearing loss is frequently found in patients with chronic renal failure (CRF). There have been many efforts to elucidate the etiologic factors of hearing loss in patients with CRF. However, there was not any clear identified cause of hearing loss. This study was undertaken to evaluate the activity of mitochondrial respiratory chain (MRC) in CRF patients with hearing impairment. To determine MRC activity, peripheral blood cells were obtained from CRF patients with hearing impairment receiving dialysis and normal subjects without any hearing problems. MRC activity of complex I and complex III was measured by the Trounces method. In MRC activities between the normal subjects group and CRF patients with hearing problems, the complex I and III activities of CRF patients with hearing problems were 63% and 85% compared with normal subjects (p<0.01). These results suggest that the activity of MRC may be implicated in the underlying mechanism of the hearing impairment in CRF patients, through mitochondrial DNA mutations at MRC complex I region with a decrement of MRC activity.

• 한방안이비인후피부과학회지
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• 제16권1호
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• pp.141-153
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• 2003

Introduction : The causes of sudden sensorineural hearing loss have not been detemined with precision until recently, but viral infections and vascular insufficiencies, such as vascular spasm, occlusion of sludging of erythrocytes were considered as major factors. The treatment has not been determined with precision until recently. It is similar to dizziness(眩暈). sudden dcafncss(暴聾) and congestion-fire deafness(痰火聾) in Oriental Medicine. It is very rare that someone has sudden hearing loss and visit Oriental Medicine Clinic right that time. But we expect if they take a Oriental treatment on thc right time. more effective for their symptom. Subjects : Following conclusions were reached by measuring results of oricntal medical treatments for 40 patients who visited the clinic between January of 2000 and December of 2002, and received treatments continuously for more than 1 months of time. Methods : Among the selected 40 patients. 30 patients belong to Group Ⅰ, which consisted of patients who had already visited a general hospital prior to visiting this clinic, achieved no recovery at all from sudden deafness despite going through more than 5 days of hospitalized treatments of steroidal medications. Group Ⅱ was consisted of 10 patients of sudden deafness who did not experience any steroidal treatments from other hospital prior to the oriental medical treatment. Results and conclusion : According to differentiation of syndrome. among 30 patients of the Group Ⅰ. 21 were categorized as excess syndrome patients and remaining 9 as deficiency syndrome paticnts. Among 10 patients of For Group Ⅱ, 5 were excess syndrome patients and remaining 5 were deficiency syndrome patients. Among Group Ⅰ, recovery ratio of excess syndrome patients was 47.7$\%$ and deficiency syndrome patients was 44.4$\%$ adding up recovery ratio of the group to be 46.1$\%$. Among Group Ⅱ, recovery ratio of excess syndrome patients was 80$\%$ and deficiency syndrome patients was 100$\%$ adding up recovery ratio of the group to be 90$\%$. Oriental medical treatments are generally more effective(90$\%$ recovery ratio) for Sudden Deafness than steroidal treatments. Oriental medical treatments are almost equally effective for both excess syndrome patients and deficiency syndrome patients. However, steroidal treatments for excess syndrom patients(45$\%$ recovery ratio) is much less effective than deficiency syndrome patients(73$\%$ recovery ratio). This indicates that steroidal treatments should be applied selectively to deficiency syndrome patients if applied at all. Even for patients with sudden deafness which hospitalized steroidal treatments did not result in any recovery at all, oriental medical treatments were able to achieve 46.1$\%$ recovery ratio.

• Journal of Genetic Medicine
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• 제14권2호
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• pp.86-89
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• 2017

Waardenburg syndrome (WS) is a rare genetic disorder, including clinical features of pigmentary abnormalities of irides, skin, hair and sensorineural hearing loss and facial dysmorphism. Among the four types, WS type IV (Waardenburg-Shah syndrome) additionally represents Hirschsprung's disease. Mutations in the SOX10, END3, or EDNRB genes are known to cause WS type IV. Here, we report a 6 year-old girl who was diagnosed as WS type IV by typical clinical manifestations, including skin hypopigmentation, heterochromia of both irides, unilateral sensorineural hearing loss, mild developmental delay and Hirschsprung's disease. The diagnosis was confirmed by molecular genetic analysis of EDNRB. Two novel EDNRB mutations were identified, and each mutation was segregated from each of her parents. During the follow-up period, the patient underwent a surgery for spleen torsion and was medically managed due to recurrent enterocolitis. Also, she suffered from impaired immunity including Hirschsprung's associated enterocolitis.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5631-5635
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• 2013

Cochlea hair cell death is regarded to be responsible for the radiation-induced sensorineural hearing loss (SNHL), which is one of the principal complications of radiotherapy (RT) for head and neck cancers. In this mini-review, we focus on the current progresses trying to unravel mechanisms of radiation-induced hair cell death and find out possible protection. P53, reactive oxygen species (ROS) and c-Jun N-terminal kinase (JNK) pathways have been proposed as pivotal in the processes leading to radiation hair cell death. Potential protectants, such as amifostine, N-acetylcysteine (NAC) and epicatechin (EC), are claimed to be effective at reducing radiation-inducedhair cell death. The RT dosage, selection and application of concurrent chemotherapy should be pre-examined in order to minimize the damage to cochlea hair cells.