OBJECTIVES: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. METHODS: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=41.50+/-13.16 yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=43.67+/-12.11 yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age 44.93+/-12.38 yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=45.87+/-12.44 yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. RESULTS: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were 991.1+/-27.1 and 875.8+/-22.0 ms (p=0.016), standard deviation of NN interval (SDNN) was 85.4+/-6.6 and 112.8+/-5.4 ms (p=0.022), SDNN index was 57.5+/-5.2 and 87.6+/-4.2 (p<0.001), total power was 11,893.5+/-1,359.9 and 18,097.0+/-1,107.2 ms2 (p=0.008), very low frequency (VLF) was 7,534.8+/-1,120.1 and 11,883.8+/-912.0 ms2 (p=0.035), low frequency (LF) was 2,724.2+/-327.8 and 4,351.6+/-266.9 ms2 (p=0.003). CONCLUSIONS: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.
Acceleration ; Anoxia ; Arousal ; Autonomic Nervous System ; Cardiovascular System ; Heart ; Heart Rate ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

No abstract available.
Gram-Positive Bacterial Infections* ; Teicoplanin*

In the recently published paper, there was a typo in the affiliation of the author. The word Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea was incorrectly spelled as Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. We hereby publish the correct affiliation as follows: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

In the recently published paper, there was a typo in the affiliation of the author. The word Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea was incorrectly spelled as Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. We hereby publish the correct affiliation as follows: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

This article provides an update on tinnitus for audiologists and other clinicians who provide tinnitus-specific services. Tinnitus can be attributable to hearing loss, somatosensory system dysfunction, or auditory cortex dysfunction, with hearing loss being the most common cause and serious underlying pathologies being rare. Hearing loss does not always lead to tinnitus, and patients with tinnitus do not always suffer from hearing loss. The first scenario is explained by a so-called inhibitory gating mechanism, whereas the second assumes that all tinnitus sufferers have some degree of hearing impairment, which might not be detected in standard audiological examinations. The treatments should aim at symptomatic relief and management of associated distress. Current treatment options include pharmacotherapy, education, counseling, cognitive behavioral therapy, and sound therapy.

BACKGROUND: Since dysthymia begins in late childhood or adolescence and has a chronic course, long-term pharmacotherapy may be required. New generation antidepressant, moclobemide, with more acceptable side effect profiles, is effective in the treatment of dysthymia. The main objective of this study was to determine whether they exhibit comparable efficacy and tolerability in dysthymia to amitriptyline. METHOD AND MATERIALS: The efficacy and tolerability of the moclobemide and amitriptyline, were compared in a eight-week single-centre double-blind study in patients(n=37) with dysthymia using he HAMD-17, the Clinical Global Impression Scale(CGI), the Montgomery-Asberg Depression Rating Scale(MADRS), Efficacy Index-Therapeutic Index(EITE), 4-point Index Side Effect Scale(4-PISES), and Efficacy Index-Side Effect Scale(EISE). RESULTS: A total of 37 patients entered the study, 19 were randomly assigned to the moclobemide group and 18 to be amitriptyline group. Demographic and illness characteristics were similar in both groups. There were no significant difference between two groups at the total 17-HDRS score, the HAMD-17% improvement, the total MADRS score, CGI response, and the EITE. In the comparison of EISE between two groups, the scores of the moclobemide group were relatively lower than the amitriptylinen group in full treatment. And the differences were significant(moclobemide group 1.39+/-0.61 ; amitriptyline group 2.00+/-0.85, p<.001). At the 4-PISE. There was no serious or treatment threatening side effects. And there was no specific difference in side effects between two groups. The moclobemide group reported higher EIR scores than the amitriptyline group at every follow up day, but the differences were not significant. And there was no significant differences in the scores of five HRQOL subcategories which is compared between two groups at every follow up days. CONCLUSIONS: In terms of 17-HDRS and MADRS, moclobemide and amitriptyline are equally effective at least in allevating dysthymic symptoms. But moclobemide tended to be less troubling and better tolerated than amitriptyline. Therefore, moclobemide treatment can be used as a safe, and higher satisfactory treatment strategy for the dysthymia.
Adolescent ; Amitriptyline* ; Depression ; Double-Blind Method ; Drug Therapy ; Dysthymic Disorder* ; Follow-Up Studies ; Humans ; Moclobemide*

This narrative review discusses the changes in the masticatory system due to the physiologic aging process in humans and how these changes should be considered when diagnosing and managing temporomandibular disorders (TMDs) in older adults. Age-related changes in the masticatory system, specifically the temporomandibular joint (TMJ) and masticatory muscles, are associated with an increased prevalence of degenerative TMJ osteoarthritis in older adults, changes in muscle function and often affect masticatory function. Considering older adults’ physiologic changes and comorbidities and their quality of life, diagnosing and managing TMDs in older adults needs a more comprehensive approach than in younger adults. Managing TMDs in older adults can improve orofacial function, such as mastication, leading to improved physical function and quality of life by reducing the risk of frailty.

This narrative review discusses the changes in the masticatory system due to the physiologic aging process in humans and how these changes should be considered when diagnosing and managing temporomandibular disorders (TMDs) in older adults. Age-related changes in the masticatory system, specifically the temporomandibular joint (TMJ) and masticatory muscles, are associated with an increased prevalence of degenerative TMJ osteoarthritis in older adults, changes in muscle function and often affect masticatory function. Considering older adults’ physiologic changes and comorbidities and their quality of life, diagnosing and managing TMDs in older adults needs a more comprehensive approach than in younger adults. Managing TMDs in older adults can improve orofacial function, such as mastication, leading to improved physical function and quality of life by reducing the risk of frailty.

This narrative review discusses the changes in the masticatory system due to the physiologic aging process in humans and how these changes should be considered when diagnosing and managing temporomandibular disorders (TMDs) in older adults. Age-related changes in the masticatory system, specifically the temporomandibular joint (TMJ) and masticatory muscles, are associated with an increased prevalence of degenerative TMJ osteoarthritis in older adults, changes in muscle function and often affect masticatory function. Considering older adults’ physiologic changes and comorbidities and their quality of life, diagnosing and managing TMDs in older adults needs a more comprehensive approach than in younger adults. Managing TMDs in older adults can improve orofacial function, such as mastication, leading to improved physical function and quality of life by reducing the risk of frailty.

This narrative review discusses the changes in the masticatory system due to the physiologic aging process in humans and how these changes should be considered when diagnosing and managing temporomandibular disorders (TMDs) in older adults. Age-related changes in the masticatory system, specifically the temporomandibular joint (TMJ) and masticatory muscles, are associated with an increased prevalence of degenerative TMJ osteoarthritis in older adults, changes in muscle function and often affect masticatory function. Considering older adults’ physiologic changes and comorbidities and their quality of life, diagnosing and managing TMDs in older adults needs a more comprehensive approach than in younger adults. Managing TMDs in older adults can improve orofacial function, such as mastication, leading to improved physical function and quality of life by reducing the risk of frailty.