Hanyang Medical Reviews最新文献

{"title":"Rehabilitation of Sensorineural Hearing Loss: Hearing Aid","authors":"J. Chung","doi":"10.7599/HMR.2015.35.2.97","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.2.97","url":null,"abstract":"Social concerns about sensorineural hearing loss have been increasing with the advent of an aging society. As most hearing loss is incurable and permanent, audiologic rehabilitation is the only option for restoring hearing. Sensorineural hearing loss includes both sensory loss of the cochlea and functional loss of the 8th cranial nerve. Because sensorineural hearing loss patients often have difficulty in understanding and locating specific sounds amidst the other ambient noise, functional amplification with hearing aids in sensorineural hearing loss is challenging work. By applying digital signal processing techniques to hearing aids, hearing rehabilitation has undergone remarkable development in recent years. Herein, the basic concepts underlying digital signal processing are reviewed briefly, followed by a short historical background of hearing aid development. The principles of hearing aid selection, counselling, frequent problems encountered in hearing aid fitting and validation are also discussed.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126851740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology and Rehabilitation of Sensorineural Hearing Loss","authors":"Seung Hwan Lee","doi":"10.7599/HMR.2015.35.2.55","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.2.55","url":null,"abstract":"Hearing is a special sense by which we perceive sound by detecting vibrations. Hearing ability is important for us to be able to interact, communicate and socialize. Sound is captured by the human ear which is a peripheral sensory organ composed of the external ear, middle ear and inner ear. The external ear serves to focus sound energy through the external auditory canal toward the tympanic membrane. The middle ear amplifies the sound energy via the ossicular chain which transfers sound vibrations to the inner ear. The inner ear includes the cochlea where mechano-electrical transduction of sound energy takes place. Humans perceive the vibrations of sound as transient auditory signals of vibratory mechanical forces transmitted through the external ear and middle ear, where they are transduced to neural signals in the inner ear passing via the auditory nerve to the central auditory system of the auditory cortex where the signal is processed and interpreted and passed on for perceptive processing. Understanding the central auditory processing in the central nervous system is essential to understanding how the sound information is discriminated and analysed to allow good communication. Any single problem in the peripheral or central auditory pathway may cause hearing impairment. Conductive hearing loss is defined as the hearing loss due to inappropriate mechanical transmission. Conditions that can cause conductive hearing loss are foreign body obstruction of the external auditory canal, perforation of the tympanic membrane, middle ear effusion, the destruction of ossicles, etc. Depending on the specific cause of conductive hearing loss, medical or surgical treatment can restore hearing. Sensorineural hearing loss refers the hearing loss caused by inner ear problems such as hair cell damage or neural degeneration. Unlike the conductive hearing loss, sensorineural hearing loss is usually permanent. Sensorineural hearing loss is divided into congenital and acquired. Congenital hearing loss may be caused by a congenital anomaly, a chromosomal syndrome or a congenital infection such as rubella or cytomegalovirus. Acquired sensorineural hearing loss might have numerous etiologic causes, including","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114473861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Middle Ear Implant","authors":"K. Hwang, J. Choi","doi":"10.7599/HMR.2015.35.2.103","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.2.103","url":null,"abstract":"이식형 보청기는 1935년 Wilska 등이 철 입자(iron particle)로 고 막을 진동시키는 실험을 하면서부터 시작되었다. Rutschmann 등 도 고막에 교차형 자기장(alternating magnetic fields)을 장치하는 연구를 진행하였다[1]. 그러나 실제 환자에게 사용이 가능한 기구 는 Yanagihara 등이 등골에 고정하는 압전기 방식의 기구(piezoelectric-type devices)를 개발하면서 가능해졌다[2]. 이후 이식형 보 청기는 크게 두 가지 방향으로 진행되었다. 먼저 골도 청력을 이용 하는 골도 보청기(bone conduction hearing aid)가 먼저 상용화되 었는데, 현재 Baha, Sophono, Ponto 등이 사용되고 있다. 이와 Hanyang Med Rev 2015;35:103-107 http://dx.doi.org/10.7599/hmr.2015.35.2.103 pISSN 1738-429X eISSN 2234-4446","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126339085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regenerative Cell Therapy for the Sensorineural Hearing Loss","authors":"K. Park","doi":"10.7599/HMR.2015.35.2.113","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.2.113","url":null,"abstract":"Sensorineural hearing loss is the most common disability in the world and nearly one third of all individuals over the age of 65 are affected. For hearing handicapped people, many devices (hearing aid, cochlear implant, middle ear implant etc.) have been developed to reduce or overcome the disability. But these devices do not give perfect benefit to the patients functionally and there are aesthetic problems. That is why researchers have interest in regenerative measures to restore or prevent hearing loss. Recently there were fruitful results from gene and stem cell therapy research for hearing loss. Gene therapy with Atoh 1 gene and transplantation of stem cells into the cochlea regenerate damaged hair cells and morphologically restore spiral ganglion neurons allowing functional hearing in the deaf animal model. Based on these results, many countries including Korea have done clinical trials in deaf patients. The past ten years have shown an incredible advancement in medical biotechnology in the otologic field and this progress may someday substitute the medical devices for the hard of hearing patients.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122445735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology of Hearing Loss and Genetic Hearing Loss","authors":"So Young Kim, B. Choi","doi":"10.7599/HMR.2015.35.2.66","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.2.66","url":null,"abstract":"Hearing loss is one of the most common sensory disorders and has numerous environmental and genetic factors that influence its onset and development. Hearing loss can be classified by either the affected anatomic or functional lesion of hearing loss, or as conductive or sensorineural hearing loss (SNHL). Genetic factors account for about 50% of congenital SNHL, and are therefore the most common cause. Molecular genetics research has identified more than 100 genes related to hearing and hearing loss, and shown that the risk of hearing loss caused by non-genetic factor is modified by genetic susceptibility. About 30% of genetic hearing loss is syndromic related and has affected phenotypic markers in other organs that make it easier to correctly diagnose the etiology of the hearing loss. In some cases, hearing loss can precede the pathologies of other organs and in these cases, hearing loss acts as a predictor of the syndrome associated pathologies of other organs. Inheritance of nonsyndromic hearing loss follows common inheritance patterns such as autosomal dominant, autosomal recessive, sex chromosome related, and mitochondrial inheritances. The paucity of predominant phenotypes and ethnic specificity of the prevalence and types of mutations may hinder the genetic diagnosis in nonsyndromic hearing loss. However, progress in elucidating the causal mutations is going forward using stratified genetic diagnostic strategies of candidate genes identified by hearing phenotypes and patterns of inheritance.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129874908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden Sensorineural Hearing Loss","authors":"G. Im, E. Park","doi":"10.7599/HMR.2015.35.2.92","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.2.92","url":null,"abstract":"Sudden sensorineural hearing loss (SSNHL) is defined as a sensorineural hearing loss of at least 30 dB in 3 consecutive speech frequencies that occurred within the previous 3 days. In most cases the cause is not identified, although various infective, vascular, and miscellaneous causes have been proposed. It has a reported incidence of 5 to 20 per 100,000 patients per year. Many treatments are used, including corticosteroids, antiviral drugs, hemodilution agents, minerals, vitamins, herbal preparations, batroxobin, carbogen, and oxygen-based treatments. Intra-tympanic dexamethasone injection into the middle ear may be useful to SSNHL patients with profound hearing loss that is intractable to medical treatment or who also have diabetes mellitus. In SSNHL, early treatment with combined modalities that include steroid injection is generally recognized as the current best practice. The spontaneous recovery rates have been reported to be between 32-70%, and although various treatment protocols have been tried, only about half of patients completely recover, usually within 2 weeks. There is much to learn about pathogenesis of sudden sensorineural hearing loss, and more clinical trials are needed to establish evidence-based management.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130274467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory Rehabilitation - Cochlear Implantation","authors":"J. Lee","doi":"10.7599/HMR.2015.35.2.108","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.2.108","url":null,"abstract":"The first cochlear implant was approved about 30 years ago. It just provided a limited sensation of sound and facilitated lip-reading based communication. Recent advances in the cochlear implant system and surgical techniques have enabled the majority of recipients to communicate orally without visual cues. The cochlear implantation has become a standard means of auditory rehabilitation for profound sensorineural deafness. To evaluate candidacy for cochlear implantation, an objective and behavioural audiological test, imaging and functional studies to identify the status of the cochlea and the auditory nerve, and evaluation of additional medical conditions are needed. Although the cochlear implantation can restore auditory function, sound perceived with the cochlear implant is different from normal hearing. Therefore postoperative rehabilitation is crucial for good speech performance. Nowadays, the indications for cochlear implantation have been extended. Hearing loss patients with residual low-frequency hearing could be candidates for cochlear implantation. Therefore, residual hearing preservation during cochlear implantation has been an important issue. In addition, bilateral cochlear implantation, cochlear implantation for single-sided deafness and fully implantable cochlear implant systems have been receiving more attention. The purpose of this article is to review current knowledge concerning the cochlear implantation.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132657306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis and Quality Assessment of Randomized Controlled Trials","authors":"Seung Wook Lee","doi":"10.7599/HMR.2015.35.1.33","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.1.33","url":null,"abstract":"Meta-analysis is the statistical combination of results from two or more separate studies. Potential advantages of meta-analyses include an increase in power, an improvement in precision, the ability to answer questions not posed by individual studies, and the opportunity to settle controversies arising from conflicting claims. However, they also have the potential to mislead seriously, particularly if specific study designs, within-study biases, variation across studies, and reporting biases are not carefully considered. It is important to be familiar with the type of data (e.g. dichotomous, continuous) that result from measurement of an outcome in an individual study, and to choose suitable effect measures for comparing intervention groups. Most meta-analysis methods are variations on a weighted average of the effect estimates from the different studies. Variation across studies (heterogeneity) must be considered. Random-effects meta-analyses allow for heterogeneity by assuming that underlying effects follow a normal distribution. Various judgments are required in the process of preparing a meta-analysis. Especially, quality assessment of randomized controlled trial is essential. There are several methods to assess the methodological quality of clinical trials, including scales, individual markers, and checklists. Analyzing the quality of studies makes the results of meta-analysis more reliable. Sensitivity analyses should be used to examine whether overall findings are robust to potentially influential decisions.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124885212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Inter-Rater Reliability in Systematic Review","authors":"Chang Un Park, Hyun Jung Kim","doi":"10.7599/HMR.2015.35.1.44","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.1.44","url":null,"abstract":"Inter-rater reliability refers to the degree of agreement when a measurement is repeated under identical conditions by different raters. In systematic review, it can be used to evaluate agreement between authors in the process of extracting data. While there have been a variety of methods to measure inter-rater reliability, percent agreement and Cohen’s kappa are commonly used in the categorical data. Percent agreement is an amount of actually observed agreement. While the calculation is simple, it has a limitation in that the effect of chance in achieving agreement between raters is not accounted for. Cohen’s kappa is a more robust method than percent agreement since it is an adjusted agreement considering the effect of chance. The interpretation of kappa can be misled, because it is sensitive to the distribution of data. Therefore, it is desirable to present both values of percent agreement and kappa in the review. If the value of kappa is too low in spite of high observed agreement, alternative statistics can be pursued.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121300217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic Strategies based on Evidence-Practice Gaps","authors":"J. Bae","doi":"10.7599/HMR.2015.35.1.3","DOIUrl":"https://doi.org/10.7599/HMR.2015.35.1.3","url":null,"abstract":"A main aim of the Evidence-based Medicine is to make the best decision by related evidence in supplying healthcare services. To apply evidence-practice gap (EPG) is very helpful to scan for what evidence is necessary. EPG gave 4 parts depending on the existence of evidence and practice. Comparative effectiveness research could be suggested in the part on conducting a practice with evidence. Translational research would be applied in the part on no practice without evidence. The adaptation of previously clinical practice guideline (CPG) should be conducted in the part on treating patients without evidence. Finally, de novo development of CPG would be undertaken in the situation of not applying the known evidence for clinical practice. These trials would bring us to a new level in improving the level of quality in the nationwide healthcare system as well as to progress achievements in the Korean medical academy.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133342515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}