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*

OBJECTIVES: To investigate brain oscillatory characteristics according to brightness and color temperature of light emitting diode (LED) light in young and elderly subjects. METHODS: We analyzed 22 young (age, 29.0±5.2 years) and 23 elderly (age, 64.8±4.5 years) healthy subjects. A LED light source was used with a combination of two color temperature (6,500 K vs. 3,000 K) and two brightness (700 lx vs. 300 lx) conditions. Participants were exposed to each light condition in relaxed wakefulness. Then, we analyzed power spectral density and functional connectivity from eye-open electroencephalography. RESULTS: A main effect of brightness on delta (p=0.044) and theta (p=0.038) power was significant in the elderly subjects. Bright light enhanced delta and theta power in the frontal region. By contrast, power spectral density of young subjects was affected by color temperature; high color temperature significantly increased beta-band power of the central region (p=0.034). Regarding functional connectivity, a significant effect of color temperature was observed in delta (p=0.006) and beta (p=0.046) frequencies. High color temperature light enhanced beta connectivity of young subjects (p=0.007), while not affecting that of elderly subjects (p=0.979). CONCLUSIONS: The present study demonstrated that spectral power and functional connectivity as well as subjective feelings are affected by the brightness and color temperature of LED light. These results might help us to understand the neurophysiological effects of light and identify the optimal indoor lighting conditions for an individual's environment.
Aged ; Brain ; Electroencephalography ; Healthy Volunteers ; Humans ; Wakefulness

BACKGROUND: Broncholithiasis is uncommon but clinically important because it may cause a variety of nonspecific symptoms and signs prior to the onset of lithoptysis, and rarely massive hemoptysis. METHOD: A retrospective clinical study was done on 11 case of broncholithiasis diagnosed at Kyungpook National University Hospital from Jan. 1985 to Dec. 1993. The study investigated the clinical features, radiologic findings, bronchoscopic findings and management. RESULTS: 1) The common symptoms included cough, dyspnea, hemoptysis, fever and purulent sputum. Lithoptysis occurred in 3 patients. 2) The radiologic findings were variable and nonspecific. Hilar calcification and parenchymal calcification were the most common findings. 3) The bronchoscopy was performed in 10 patients and revealed broncholiths in 9 patients. 4) Chemical composition of broncholiths was analyzed in 2 patients. Calcium carbonate was main component. 5) In 6 out of 9 patients in whom broncholiths was revealed by bronchoscopy, broncholiths were successfully extracted through the flexible bronchoscope. 6) In 9 patients, broncholithiasis was related to tuberculosis and in 1 case, related to silicosis. CONCLUSION: Broncholithiasis shows a variable clinical spectrum. Tuberculosis is the most common cause of broncholithiasis. In the case of no accompanied complication, nonsurgical management such as bronchoscopic removal and conservative therapy is an effective measure.
Bronchoscopes ; Bronchoscopy ; Calcium Carbonate ; Cough ; Dyspnea ; Fever ; Gyeongsangbuk-do ; Hemoptysis ; Humans ; Retrospective Studies ; Silicosis ; Sputum ; Tuberculosis

BACKGROUND AND OBJECTIVES: Subjective tinnitus, a distracting internal noise, is experienced by humans. Tinnitus is evoked by salicylic acid treatment in rats as confirmed by Jastreboff in 1994 in an animal behavior model of tinnitus with salicylic acid. The objective of this study is to evaluate c-fos expression in the brain stem of rats after salicylic acid treatment. MATERIALS AND METHOD: After salicylic acid (450 mg/kg) and saline treatment (450 mg/kg), c-fos immunohistochemical staining expression in the auditory and nonauditory brain stem nuclei were observed. RESULTS: Many immunoreactive cells were observed in the Locus Ceruleus of the salicylic acid treated animals, but not in the saline treated animals. No immunoreactive cells were found in the auditory brain stem nuclei. CONCLUSION: The Locus Ceruleus is the nucleus of the brain stem and produce norepinephrine which results in arousal of the neuronal activity for stress. These results suggest that salicylic acid may evoke tinnitus through a combined effect on the auditory and nonauditory brain nuclei. It seems possible that the interaction of these effects at particular locations of the brain causes tinnitus.
Animals ; Arousal ; Behavior, Animal ; Brain Stem* ; Brain* ; Humans ; Locus Coeruleus ; Neurons ; Noise ; Norepinephrine ; Rats* ; Salicylic Acid* ; Tinnitus

Background: This study explored the effect of anger on suicidality by dividing participants into a group with major depressive disorder (MDD) and a non-MDD group, and also investigated whether the anger expression affects suicidality in participants without clinical depression. Methods: A total of 1,015 residents responded to anonymous questionnaires in our survey. The survey included scales, such as the Patients Health Questionnaire-9 (PHQ-9), Korean State-Trait Anger Expression Inventory, and Mini-International Neuropsychiatric Interview-Plus. Participants were categorized into the MDD and non-MDD groups or depression group and non-depression group following the PHQ-9 score. Logistic regression analysis was performed to confirm the association between anger and suicidality in the non-MDD and non-MDD groups. Results: Anger suppression and higher PHQ-9 appeared as risk factors for suicidality in the non-MDD group. The depression level in the non-MDD group mediates the relationship between anger suppression and suicidality. Higher PHQ-9 was no longer a risk factor and anger suppression remains a risk factor in the non-depression group. Conclusion Not only depression evaluation, but also anger evaluation is important when assessing suicidality. Implementing anger management programs for people with high anger suppression can help lower suicidality in Korean society, where negative emotional expression is suppressed.

BACKGROUND: Chest wall deformities such as kyphoscoliosis, thoracoplasty, and fibrothorax cause ventilatory insufficiency that can lead to chronic respiratory failure, with recurrent fatal acute respiratory failure(ARF). This study evaluated the frequency and outcome of ARF, the physiologic status, and the long-term prognosis of these patients. METHODS: Twenty-nine patients with chest wall disorders, who experienced the first requirement of ventilatory support from ARF were examined. The mortality and recurrence rate of ARF, the pulmonary functions with arterial blood gas analysis, the efficacy of home oxygen therapy, and the long-term survival rate were investigated. RESULTS: 1) The mortality of the first ARF was 24.1%. ARF recurred more than once in 72.7% of the remaining 22 patients, and overall rate of successful weaning was 73.2%. 2) Twenty-two patients who recovered from the first ARF showed a restrictive ventilatory impairment with a mean FVC and TLC of 37.2% and 62.4 % of predicted value, respectively, and a mean PaCO2 of 57mmHg. Among the parameters of pulmonaty functions. the FVC(p=0.01) and VC(p=0.02) showed a significant correlation with the PaCO2 level. 3) There were no significant differences between the patients treated with conservative medical treatment only and those with additional home oxygen therapy due to significant hypoxemia in the patients with recurrent ARF and the mortality. 4) The 1, 3, 5-year survival rates were 75%, 66%, and 57%, respectively, in the 20 patients who had recovered from the first ARF, excluding the two patients managed by non-invasive nocturnal ventilatory support. CONCLUSION: These results suggest that active ventilatory support should be provided to patients with ARF and chest wall disorders. However, considering recurrent ARF and weak effect of home oxygen therapy, non-invasive domiciliary ventilation is recommended in those patients with these conditions to achieve a better long-term prognosis.
Anoxia ; Blood Gas Analysis ; Congenital Abnormalities ; Humans ; Mortality ; Oxygen ; Prognosis* ; Recurrence ; Respiratory Insufficiency ; Survival Rate ; Thoracic Wall* ; Thoracoplasty ; Thorax* ; Ventilation ; Weaning

BACKGROUND: Pleural effusion develops in approximately 40% of pneumonia patients. In 5-10% of these cases, it progresses to complicated parapneumonic effusion (CPPE) or empyema that requires drainage. The prognostic factors of CPPE and empyema remain to be clarified. We examined the treatment outcomes of CPPE and empyema and elucidating their prognostic factors. METHODS: One hundred and fifteen patients with CPPE or empyema, who were diagnosed and treated in Kyungpook National University Hospital (Daegu, Korea) between September 2001 and December 2005, were retrospectively analyzed. All the data was acquired from their chart review, and regarding treatment results, the time to defervescence and the length of hospital stay were analyzed. RESULTS: The treatment was successful in 101 patients with a success rate of 87.8%. Multivariate analysis showed the level of pleural fluid lactate dehydrogenase (LDH) to be a significant prognostic factor (odds ratio [OR] 7.37; 95% confidence interval [CI], 1.63 to 33.37; p=0.009). Pussy pleural fluid (r=0.236; p=0.01) and the frequency of urokinase use (r=0.257; p=0.01) correlated with the time to defervescence. However, there was no clinical factor that correlated with the length of hospital stay. CONCLUSION: The pleural fluid LDH level is a useful prognostic factor for monitoring treatment results of CPPE and empyema.
Drainage ; Empyema* ; Gyeongsangbuk-do ; Humans ; L-Lactate Dehydrogenase ; Length of Stay ; Multivariate Analysis ; Pleural Effusion ; Pneumonia ; Prognosis ; Retrospective Studies ; Urokinase-Type Plasminogen Activator

OBJECTIVE: This study was designed to investigate the association of ALDH2 genetic types with the risk and clinical variables of alcohol dependence in Korean patients. METHODS: ALDH2 genotypes were typed with restriction fragment length polymorphism method in 141 patients with alcohol dependence and 144 normal controls. The frequencies of ALDH2 genetic types were compared between patients and controls. Among the patients, the frequencies of ALDH2 genotypes were compared in terms of clinical variables. RESULTS: 1) The genotypic frequencies of the subjects with ALDH2*1/1 were higher and those with variant ALDH2, that is, ALDH2*1/2 and ALDH2*2/2 were lower in patients than in normal controls. 2) The genetic frequencies of the patients with ALDH2 were not related to family history of alcohol dependence. 3) There were no differences for the age of first drink and onset age of alcohol dependence between the patients with ALDH2*1/1 and those with ALDH2*1/2 or ALDH2*2/2. CONCLUSION: These results suggest ALDH2 genotypes might be associated with the risk of alcohol dependence.
Age of Onset ; Alcoholism* ; Aldehyde Dehydrogenase* ; Genotype ; Humans ; Molecular Biology ; Polymorphism, Restriction Fragment Length

Background: Despite the critical importance of sleep medicine within neurology, notable gaps in education and clinical practice persist among neurologists. This study aims to explore the extent of involvement and the challenges faced by Korean neurologists in sleep medicine, focusing on awareness of polysomnography training program, the operation of sleep study facilities, and educational exposure. Methods: An online survey collected responses from 233 neurologists, focusing on their demographics, knowledge of and involvement in sleep medicine, operation of sleep study facilities, and participation in residency training. Results: The findings indicated that 84.9% of neurologists were aware of polysomnography training program, primarily through professional societies. Nonetheless, 15.1% reported unfamiliarity with these initiatives, with 72.7% of this subgroup expressing interest in sleep medicine yet lacking access to information. In terms of clinical practice, 74 neurologists operated sleep study facilities, with 63% intending to expand. Key operational challenges included staff management, maintaining patient volumes, and inadequate institutional support. Among respondents from teaching hospitals, only 36 out of 114 reported active resident involvement in sleep study interpretations, predominantly hindered by excessive workloads and insufficient staffing. Conclusions A significant number of neurologists have an interest in sleep medicine; however, substantial challenges impede effective education and clinical practice. These results underscore the need for improved educational resources and institutional support to enhance the growth and effectiveness of sleep medicine practices among neurologists.

Background: Despite the critical importance of sleep medicine within neurology, notable gaps in education and clinical practice persist among neurologists. This study aims to explore the extent of involvement and the challenges faced by Korean neurologists in sleep medicine, focusing on awareness of polysomnography training program, the operation of sleep study facilities, and educational exposure. Methods: An online survey collected responses from 233 neurologists, focusing on their demographics, knowledge of and involvement in sleep medicine, operation of sleep study facilities, and participation in residency training. Results: The findings indicated that 84.9% of neurologists were aware of polysomnography training program, primarily through professional societies. Nonetheless, 15.1% reported unfamiliarity with these initiatives, with 72.7% of this subgroup expressing interest in sleep medicine yet lacking access to information. In terms of clinical practice, 74 neurologists operated sleep study facilities, with 63% intending to expand. Key operational challenges included staff management, maintaining patient volumes, and inadequate institutional support. Among respondents from teaching hospitals, only 36 out of 114 reported active resident involvement in sleep study interpretations, predominantly hindered by excessive workloads and insufficient staffing. Conclusions A significant number of neurologists have an interest in sleep medicine; however, substantial challenges impede effective education and clinical practice. These results underscore the need for improved educational resources and institutional support to enhance the growth and effectiveness of sleep medicine practices among neurologists.