Cis-diamminedichloroplatinum(II) (cisplatin), platinum compound, is an anti-cancer agent currently used for the treatment of a number of human solid cancers. It irreversibly reacts with DNA to form an interconnection between guanine-group helices, resulting in cell death. Furthermore, it is also associated with numerous adverse effects such as nephrotoxicity, neurotoxicity, and ototoxicity. Hearing loss due to cisplatin ototoxicity is usually permanent and bilateral. Many studies have been conducted on the ototoxicity of cisplatin, however, its pathology and treatment have not been fully elucidated. Studies have reported that cisplatin inhibits the action of adenylate cyclase in the stria vascularis, and hearing loss occurs due to a decrease in the receptor current of the outer hair cells. In addition, it has been reported that morphological changes in the inner ear include changes in outer hair cells and abnormal findings in the supporting cells of the organ of Corti and Reissner’s membrane. Oxidative stress is known to be the main cause of ototoxicity. In addition, it has recently been suggested that inflammation may trigger inner ear cell death through autophagy, necrosis, and endogenous apoptosis. In this review, we intend to provide a basis for the prevention strategy of cisplatin-induced ototoxicity by revealing its molecular targets and intracellular pathways.

Subjective tinnitus can be defined as sound sensations (ringing or roaring) occurring in the absence of external auditory stimulus. It is one of the most widespread disorders of auditory system that might be caused by the peripheral auditory injury and insults to somatosensory levels. There were some theories in pathophysiology of tinnitus, such as change in biochemical systems, discordant dysfunction, and spontaneous hyperactivity of auditory tract or imbalance between inhibitory and excitatory transmitter actions of central auditory tracts. Theories related to neural plasticity and cortical reorganization have been recently introduced. Current understanding of pathophysiology in tinnitus is essential to therapeutic approaches. Although there were many studies addressing pathophysiology of tinnitus, controversies exist regarding the pathophysiology of tinnitus. The aim of this review was to review and summarize the recent studies related to pathophysiology of tinnitus.
Plastics ; Sensation ; Tinnitus*

BACKGROUND: The present study aimed to evaluate the clinical association between cadmium exposure and hearing impairment among the Korean population.METHODS: This retrospective cross-sectional study used the data obtained from the Korean National Health and Nutrition Examination Survey were used for our study. Finally, 3,228 participants were included in our study, which were then divided into quartiles based on their blood cadmium levels: first quartile (1Q), second quartile (2Q), third quartile (3Q), and fourth quartile (4Q) groups. The hearing thresholds were measured using an automatic audiometer at 0.5, 1, 2, 3, 4, and 6 kHz. Hearing loss (HL) was defined as >25 dB average hearing threshold (AHT).RESULTS: All the groups had 807 participants each. The area under the receiver operating characteristic curves of cadmium level for HL were 0.634 (95% confidence interval [CI], 0.621–0.646). The participants in the 4Q group had higher Low/Mid-Freq, High-Freq, and AHT values than those in the other groups in the multivariate analysis after adjusting for confounding factors. The logistic regression showed that the OR for HL per 1 µg/L increase in cadmium was 1.25 (95% CI, 1.09–1.44; p=0.002) on the multivariate analysis. Moreover, the multivariate logistic regression analyses revealed that the participants in the 4Q group exhibited a 1.59-, 1.38-, and 1.41-fold higher odds for HL than those in the 1Q, 2Q, and 3Q groups, respectively.CONCLUSION: High cadmium level quartile was associated with increased hearing thresholds and HL among the Korean adult population.
Adult ; Cadmium ; Cross-Sectional Studies ; Hearing Loss ; Hearing ; Humans ; Logistic Models ; Metals, Heavy ; Multivariate Analysis ; Nutrition Surveys ; Retrospective Studies ; ROC Curve

BACKGROUND: The present study aimed to evaluate the clinical association between cadmium exposure and hearing impairment among the Korean population. METHODS: This retrospective cross-sectional study used the data obtained from the Korean National Health and Nutrition Examination Survey were used for our study. Finally, 3,228 participants were included in our study, which were then divided into quartiles based on their blood cadmium levels: first quartile (1Q), second quartile (2Q), third quartile (3Q), and fourth quartile (4Q) groups. The hearing thresholds were measured using an automatic audiometer at 0.5, 1, 2, 3, 4, and 6 kHz. Hearing loss (HL) was defined as >25 dB average hearing threshold (AHT). RESULTS: All the groups had 807 participants each. The area under the receiver operating characteristic curves of cadmium level for HL were 0.634 (95% confidence interval [CI], 0.621–0.646). The participants in the 4Q group had higher Low/Mid-Freq, High-Freq, and AHT values than those in the other groups in the multivariate analysis after adjusting for confounding factors. The logistic regression showed that the OR for HL per 1 µg/L increase in cadmium was 1.25 (95% CI, 1.09–1.44; p=0.002) on the multivariate analysis. Moreover, the multivariate logistic regression analyses revealed that the participants in the 4Q group exhibited a 1.59-, 1.38-, and 1.41-fold higher odds for HL than those in the 1Q, 2Q, and 3Q groups, respectively. CONCLUSION High cadmium level quartile was associated with increased hearing thresholds and HL among the Korean adult population.

In this comprehensive review, we discuss recent updates on tinnitus evaluation and treatment. Tinnitus evaluation commences with comprehensive medical history taking and audiological evaluation, which can provide valuable insight into the nature and extent of auditory disturbances. Additionally, tinnitus evaluation includes investigation of psychosomatic comorbidities to determine the intricate interplay between psychological factors and tinnitus perception. Various therapeutic approaches are available to minimize the burden of tinnitus. Cognitive behavioral therapy reshapes negative thought patterns and behaviors that are closely associated with tinnitus-induced distress. Acceptance and commitment therapy fosters mindfulness and value-aligned actions to address emotional effects. Tinnitus retraining therapy combines counseling and sound therapy for habituation. Tailor-made notched music therapy offers customized auditory experiences for symptom relief. Hearing aids and cochlear implants compensate for hearing loss and associated stress. Both neuromodulation and neurofeedback may be potentially useful. The role of pharmacotherapy and dietary supplements remains uncertain. Physiotherapy and head-neck manipulation relieve tinnitus associated with orofacial factors. Virtual reality, smartphone applications, and photobiomodulation may serve as novel therapeutic avenues. Although promising interventions are available, further research is warranted to confirm their effectiveness and long-term effects.

In pre-surgical evaluation of pediatric epilepsy, the combined use of multiple imaging modalities for precise localization of the epileptogenic focus is a worthwhile endeavor. Advanced neuroimaging by high field Magnetic resonance imaging (MRI), diffusion tensor images, and MR spectroscopy have the potential to identify subtle lesions. 18F-FDG positron emission tomography and single photon emission tomography provide visualization of metabolic alterations of the brain in the ictal and interictal states. These techniques may have localizing value for patients which exhibit normal MRI scans. Functional MRI is helpful for non-invasively identifying areas of eloquent cortex. These advances are improving our ability to noninvasively detect epileptogenic foci which have gone undetected in the past and whose accurate localization is crucial for a favorable outcome following surgical resection.
Brain ; Diffusion ; Epilepsy ; Fluorodeoxyglucose F18 ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Neuroimaging ; Positron-Emission Tomography

PURPOSE: The purpose of this study was to investigate the relationship among knowledge and attitude toward palliative care and perception of death for Neonatal Intensive Care Unit (NICU) nurses. METHODS: A cross-sectional descriptive study was conducted with 110 nurses who work in NICUs in South Korea. The participants filled out a questionnaire regarding their knowledge, attitude towards palliative care and perception of death. The attitude scale was divided into 3 subscales: comfort level, nurses' role and nurses' involvement with family. RESULTS: Comfort level regarding attitude towards palliative care was positively correlated with knowledge (r=.220, p=.016) and the perception of death (r=.194, p=.042). Nurses' role showed a positive correlation with perception of death (r=.395, p=.001). CONCLUSION: NICU nurses' knowledge of palliative care was below standard across the board, implying that there is a definite need for palliative care education for nurses. The education program for palliative care should include a section that focuses on fostering a positive perception of death as well as defining and delineating the role of nurses.
Education ; Foster Home Care ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal* ; Intensive Care, Neonatal* ; Korea ; Palliative Care*

Idiopathic pulmonary fibrosis (IPF), based on the 2018 international clinical practice guidelines, can be diagnosed with a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) and compatible clinical findings. Given that imaging is pivotal for IPF evaluation and diagnosis, more emphasis should be placed on the integration of clinical, radiological, and pathologic findings for multidisciplinary diagnosis. Interstitial lung abnormality (ILA), on the other hand, has a purely radiological definition based on the incidental identification of CT abnormalities. Taken together, differentiation between ILA and clinically significant interstitial lung disease (ILD) must be based on proper clinical evaluation. With this review, the recent updates in IPF diagnosis and the radiologic considerations for ILA can be well understood, which can be helpful for the proper diagnosis and management of patients with diffuse interstitial pulmonary fibrosis.

Bleeding after endoscopic submucosal dissection (ESD), one of the most common postprocedural adverse events, is the main cause of increased readmission rates and hospital costs. Generally, the incidence of post-ESD bleeding is estimated to be about 5%. However, the incidence of bleeding is particularly increased in high-risk patients. In particular, it has an incidence of over 50% in patients that use antithrombotic agents. The well-known risk factors for post-ESD bleeding include antithrombotic therapy, lesions in the proximal stomach, specimen size >4 cm, and concomitant renal disease. Currently, the number of patients at a high risk of post-ESD bleeding has been increasing. This may be due to the aging society and the increase in the usage of antithrombotic agents. Therefore, several strategies have been employed to prevent post-ESD bleeding. These strategies include acid inhibition therapy, preventive hemostasis using Doppler endoscopic ultrasound and artery-selective clipping, second look endoscopy, the closings method, and the shield methods. However, these methods are technically demanding, which hinders their wide usage in clinical practice. Recently, several hemostatic powders have been developed and clinically used in the treatment of gastrointestinal bleeding. In this article, we review the risk factors for post-ESD bleeding and the recently introduced prevention methods. Moreover, we aimed to explore realistic and appropriate strategies for the prevention of post-ESD bleeding.

Bleeding after endoscopic submucosal dissection (ESD), one of the most common postprocedural adverse events, is the main cause of increased readmission rates and hospital costs. Generally, the incidence of post-ESD bleeding is estimated to be about 5%. However, the incidence of bleeding is particularly increased in high-risk patients. In particular, it has an incidence of over 50% in patients that use antithrombotic agents. The well-known risk factors for post-ESD bleeding include antithrombotic therapy, lesions in the proximal stomach, specimen size >4 cm, and concomitant renal disease. Currently, the number of patients at a high risk of post-ESD bleeding has been increasing. This may be due to the aging society and the increase in the usage of antithrombotic agents. Therefore, several strategies have been employed to prevent post-ESD bleeding. These strategies include acid inhibition therapy, preventive hemostasis using Doppler endoscopic ultrasound and artery-selective clipping, second look endoscopy, the closings method, and the shield methods. However, these methods are technically demanding, which hinders their wide usage in clinical practice. Recently, several hemostatic powders have been developed and clinically used in the treatment of gastrointestinal bleeding. In this article, we review the risk factors for post-ESD bleeding and the recently introduced prevention methods. Moreover, we aimed to explore realistic and appropriate strategies for the prevention of post-ESD bleeding.