BACKGROUND AND OBJECTIVES: Electrical stimulation is one of various methods of treatment for patients suffering from tinnitus. However, the effect or mechanism of electrical stimulation is still unclear. Also, although the success rate of electrical stimulation ranged from 13% to 80% in other studies, the best condition of electrical stimulation is unknown yet. The purpose of this study is to elucidate the effect of alternate current electrical stimulation at tympanic membrane on tinnitus suppression and to seek the best condition that yield maximum tinnitus reduction. SUBJECTS AND METHOD: Forty-five patients who suffered from tinnitus with moderately severe hearing loss above 56 dB and 20 patients with limited frequency hearing loss above 56 dB were selected for this study. The study was performed in 4 phases. Fourty-five patients who passed the screening phase received 10 min duration of electrical stimulation twice a week for 6 weeks. RESULTS: The results were as follows. 1) Among the 65 patients, alternate current stimulation suppressed tinnitus in 45 patients (69%) in the screening phase. So 45 patients were selected for the electrical stimulation group. 2) Tinnitus suppression was most effective in patients with sudden deafness in the screening phase. 3) Effective tinnitogram for electrical stimulation was white noise and 8 kHz (pure tone) in the screening phase. 4) The most common optimal stimulation was the low frequency square wave. 5) The mean intensity of the current was 47.5 microliterA. 6) Suppression of tinnitus was achieved in 30 patients (67%) among 45 patients who received electrical stimulation therapy. 7) Long term treatment was more effective than short term, but adaptation phenomenon was noted during the treatment phase in 15 patients (33%). CONCLUSION: These results showed that alternate current stimulation for patients with tinnitus is effective and that the optimal condition to use is the low frequency square wave. We found good response to electrical stimulation in patients with sudden deafness and moderate to severe hearing loss. Therefore, we think electrical stimulation is a good treatment for patients with tinnitus for whom it is difficult to apply TRT (tinnitus retraining therapy).
Electric Stimulation Therapy ; Electric Stimulation* ; Hearing Loss ; Hearing Loss, Sudden ; Humans ; Mass Screening ; Noise ; Tinnitus* ; Tympanic Membrane*

The patient with pulsatile tinnitus can bo annoying and the tinnitus can be the only clue to a potentially devastating and life-threatening disease, too. This tinnitus may originate from the arterial, arteriovenous, venous vessels and the myoclonus. Occasionally it is the cause of underlying condition in increased flow volume such as anemia, hyperthyroidism, pregnancy, medication or increased intracranial pressure. And then control of these underlying condition is important treatment in those occasions. If anyone suffered from venous pulsatile tinnitus, then simple ligation of the internal jugular vein could be the simplest treatment. Recently the authors experienced a case of 28-year-old woman with left pulsatile tinnitus originating from venous hum. The tinnitus had developed at fourth month of pregnancy and persisted after 20 months of delivery. The patient was treated by ligation of the internal jugular vein in local anesthesia. The proper ligation site was decided by angiography. She remains free of symptoms and complications 7 months after treatment.
Adult ; Anemia ; Anesthesia, Local ; Angiography ; Female ; Humans ; Hyperthyroidism ; Intracranial Pressure ; Jugular Veins* ; Ligation* ; Myoclonus ; Pregnancy* ; Tinnitus ; Veins

Antiviral Agents ; chemistry ; metabolism ; Crystallography, X-Ray ; Ligands ; Protein Binding ; Protein Structure, Tertiary ; RNA Helicases ; chemistry ; classification ; metabolism ; Static Electricity ; Viral Proteins ; chemistry ; classification ; metabolism ; Zika Virus ; enzymology

The recent explosive outbreak of Zika virus (ZIKV) infection has been reported in South and Central America and the Caribbean. Neonatal microcephaly associated with ZIKV infection has already caused a public health emergency of international concern. No specific vaccines or drugs are currently available to treat ZIKV infection. The ZIKV helicase, which plays a pivotal role in viral RNA replication, is an attractive target for therapy. We determined the crystal structures of ZIKV helicase-ATP-Mn(2+) and ZIKV helicase-RNA. This is the first structure of any flavivirus helicase bound to ATP. Comparisons with related flavivirus helicases have shown that although the critical P-loop in the active site has variable conformations among different species, it adopts an identical mode to recognize ATP/Mn(2+). The structure of ZIKV helicase-RNA has revealed that upon RNA binding, rotations of the motor domains can cause significant conformational changes. Strikingly, although ZIKV and dengue virus (DENV) apo-helicases share conserved residues for RNA binding, their different manners of motor domain rotations result in distinct individual modes for RNA recognition. It suggests that flavivirus helicases could have evolved a conserved engine to convert chemical energy from nucleoside triphosphate to mechanical energy for RNA unwinding, but different motor domain rotations result in variable RNA recognition modes to adapt to individual viral replication.
Crystallography, X-Ray ; Protein Domains ; RNA Helicases ; chemistry ; RNA, Viral ; chemistry ; Viral Proteins ; chemistry ; Zika Virus ; enzymology