Pub Date : 2016-08-01DOI: 10.7599/HMR.2016.36.3.174
M. Kang
Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and some- times life-threatening hypersensitivity mucocutaneous disease triggered mostly by medi- cation and infections Major involving tissues are the mucous membranes of oral, gastroin- testinal, respiratory, integument, and gynecologic tissues. Even after recovering from skin problems without sequelae, survivors can have serious ocular complications leading to blindness despite local and systemic therapy. There is no definite effective systemic and lo- cal treatment for SJS/TEN. Early detection and aggressive treatment are important for the long-term prognosis of the eye. Eyelid margin and palpebral conjunctiva and fornix should be checked thoroughly to detect the cicatrical changes that make chronic ocular surface failure such as limbal cell deficiency and complete ocular surface keratinization. Amniotic membrane transplantation and cultivated oral mucosal graft are beneficial to reduce the risk of ocular surface failure.
{"title":"Ocular Manifestations of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis","authors":"M. Kang","doi":"10.7599/HMR.2016.36.3.174","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.3.174","url":null,"abstract":"Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and some- times life-threatening hypersensitivity mucocutaneous disease triggered mostly by medi- cation and infections Major involving tissues are the mucous membranes of oral, gastroin- testinal, respiratory, integument, and gynecologic tissues. Even after recovering from skin problems without sequelae, survivors can have serious ocular complications leading to blindness despite local and systemic therapy. There is no definite effective systemic and lo- cal treatment for SJS/TEN. Early detection and aggressive treatment are important for the long-term prognosis of the eye. Eyelid margin and palpebral conjunctiva and fornix should be checked thoroughly to detect the cicatrical changes that make chronic ocular surface failure such as limbal cell deficiency and complete ocular surface keratinization. Amniotic membrane transplantation and cultivated oral mucosal graft are beneficial to reduce the risk of ocular surface failure.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125119835","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.120
Joong-Wook Shin, Ho‐Ki Lee
According to the Jastreboff’s neurophysiological model of tinnitus, if negative associations are attached to the tinnitus signal, tinnitus is perceived to be a threat or a danger and it activates the autonomic nervous and limbic systems. Consequently patient’s awareness of tinnitus is heightened and so patient perceives it to be louder and more persistent. Jastreboff and Hazell started tinnitus retraining therapy (TRT) based on the neurophysiological model of tinnitus. The purpose of TRT is blocking tinnitus from activating the sympathetic nervous and limbic systems (habituation of reaction) and from reaching the cerebral cortex (habituation of perception). TRT is composed of two components directive counseling that tries to reclassify tinnitus into the meaningless stimuli and sound therapy that decreases the relative strength of the tinnitus signal. Physicians try to put patient’s tinnitus into the territory of meaningless stimuli through retraining the brain (habituation of reaction). Because the brain habituates all unimportant stimuli, if habituation of reaction is fully achieved, habituation of perception will follow automatically. In most clinical results, clinical success rates of TRT approach or exceed 80% improvement. Early improvement can be achieved during the first few months, followed by additional progressive improvement. It should be recommended that the patient continue treatment at least 18 months.
{"title":"Tinnitus Retraining Therapy","authors":"Joong-Wook Shin, Ho‐Ki Lee","doi":"10.7599/HMR.2016.36.2.120","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.120","url":null,"abstract":"According to the Jastreboff’s neurophysiological model of tinnitus, if negative associations are attached to the tinnitus signal, tinnitus is perceived to be a threat or a danger and it activates the autonomic nervous and limbic systems. Consequently patient’s awareness of tinnitus is heightened and so patient perceives it to be louder and more persistent. Jastreboff and Hazell started tinnitus retraining therapy (TRT) based on the neurophysiological model of tinnitus. The purpose of TRT is blocking tinnitus from activating the sympathetic nervous and limbic systems (habituation of reaction) and from reaching the cerebral cortex (habituation of perception). TRT is composed of two components directive counseling that tries to reclassify tinnitus into the meaningless stimuli and sound therapy that decreases the relative strength of the tinnitus signal. Physicians try to put patient’s tinnitus into the territory of meaningless stimuli through retraining the brain (habituation of reaction). Because the brain habituates all unimportant stimuli, if habituation of reaction is fully achieved, habituation of perception will follow automatically. In most clinical results, clinical success rates of TRT approach or exceed 80% improvement. Early improvement can be achieved during the first few months, followed by additional progressive improvement. It should be recommended that the patient continue treatment at least 18 months.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114690681","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.131
Y. Ko
{"title":"Microvascular Decompression for Tinnitus","authors":"Y. Ko","doi":"10.7599/HMR.2016.36.2.131","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.131","url":null,"abstract":"","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124346291","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.92
Eun-Young Jang, J. Yi
Tinnitus is usually perceived as a continuous buzzing, hissing or ringing sound in the ears [1]. Subjective tinnitus, the most common form of tinnitus is only perceived to a tinnitus patient and there is no corresponding sound source. On the contrary, the perceived noise has its source within a patient’s body in objective tinnitus cases. About 90% of all tinnitus cases are accompanied by hearing loss [2] which is a risk factor of tinnitus [3]. Even though it is a fact that tinnitus has a high prevalence and results in disturbances, researchers assume that the mechanism to develop and maintain tinnitus is not fully understood [4]. Previous research showed that 35-45% of adults have subjective tinnitus at some point in their life [5], 8-15% of adults suffer from tinnitus [6], and 18% of people in industrialized societies are mildly affected by chronic tinnitus [7]. However, it is not clear what the factors are for onset, persistence, severity, and adverse effect of tinnitus. There had been some biomedical models explaining the relation between tinnitus and a physiological mechanism, neurological mechanism, and immunological mechanism, which were supported by some empirical studies. These models showed limitations to find out the cause and result of tinnitus, and since then, more attention has been paid to other factors beyond the biomedical models. One of the most popular factors was personalities or psychological aspects. This review will deal with psychological factors related to tinnitus through the empirical studies done so far and discuss the direction of future studies on personality factors. Before reviewing the relation between tinnitus and personality aspects further, the issue of psychiatric disorders needs to be addressed. Knowing the effects of psychiatric disorders on tinnitus is helpful to understand neurological causes of tinnitus as well as to find out the neurological changes caused by tinnitus because psychiatric disorders include the physical mechanism. It is also helpful to understand the personality or temperament factors since psychiatric disorders embrace the psychological explanation of tinnitus. Hanyang Med Rev 2016;36:92-98 http://dx.doi.org/10.7599/hmr.2016.36.2.92 pISSN 1738-429X eISSN 2234-4446
{"title":"The Role of Psychological Factors in Tinnitus","authors":"Eun-Young Jang, J. Yi","doi":"10.7599/HMR.2016.36.2.92","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.92","url":null,"abstract":"Tinnitus is usually perceived as a continuous buzzing, hissing or ringing sound in the ears [1]. Subjective tinnitus, the most common form of tinnitus is only perceived to a tinnitus patient and there is no corresponding sound source. On the contrary, the perceived noise has its source within a patient’s body in objective tinnitus cases. About 90% of all tinnitus cases are accompanied by hearing loss [2] which is a risk factor of tinnitus [3]. Even though it is a fact that tinnitus has a high prevalence and results in disturbances, researchers assume that the mechanism to develop and maintain tinnitus is not fully understood [4]. Previous research showed that 35-45% of adults have subjective tinnitus at some point in their life [5], 8-15% of adults suffer from tinnitus [6], and 18% of people in industrialized societies are mildly affected by chronic tinnitus [7]. However, it is not clear what the factors are for onset, persistence, severity, and adverse effect of tinnitus. There had been some biomedical models explaining the relation between tinnitus and a physiological mechanism, neurological mechanism, and immunological mechanism, which were supported by some empirical studies. These models showed limitations to find out the cause and result of tinnitus, and since then, more attention has been paid to other factors beyond the biomedical models. One of the most popular factors was personalities or psychological aspects. This review will deal with psychological factors related to tinnitus through the empirical studies done so far and discuss the direction of future studies on personality factors. Before reviewing the relation between tinnitus and personality aspects further, the issue of psychiatric disorders needs to be addressed. Knowing the effects of psychiatric disorders on tinnitus is helpful to understand neurological causes of tinnitus as well as to find out the neurological changes caused by tinnitus because psychiatric disorders include the physical mechanism. It is also helpful to understand the personality or temperament factors since psychiatric disorders embrace the psychological explanation of tinnitus. Hanyang Med Rev 2016;36:92-98 http://dx.doi.org/10.7599/hmr.2016.36.2.92 pISSN 1738-429X eISSN 2234-4446","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124296962","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.81
J. Chung, Seung Hwan Lee
Tinnitus represents a phantom auditory sensation without an external sound source. The reported prevalence of tinnitus estimates 15-20% in world population. Although severe tinnitus might be associated with deterioration of quality of life, depression and anxiety, treatment modalities of tinnitus have not been established yet. Considering the heterogeneity of tinnitus, a single theory or a hypothesis cannot sufficiently explain the mechanism of tinnitus. Thus, diverse theories and studies had been conducted to elucidate the secret of tinnitus. Degeneration of outer hair cell in the peripheral auditory system is known to be associated with tinnitus, while auditory plasticity theory, upregulation of excitation of central auditory structures explains the role of the central auditory pathway in the generation of tinnitus. In addition, somatosensory and limbic autonomic nervous systems are also deeply involved with the pathogenesis of tinnitus. Herein, recent pathophysiologic theories and remarkable studies of tinnitus were reviewed. Understanding of the mechanism of the tinnitus generation might be the cornerstone in the development of tinnitus treatment.
{"title":"The Pathophysiologic Mechanism of Tinnitus","authors":"J. Chung, Seung Hwan Lee","doi":"10.7599/HMR.2016.36.2.81","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.81","url":null,"abstract":"Tinnitus represents a phantom auditory sensation without an external sound source. The reported prevalence of tinnitus estimates 15-20% in world population. Although severe tinnitus might be associated with deterioration of quality of life, depression and anxiety, treatment modalities of tinnitus have not been established yet. Considering the heterogeneity of tinnitus, a single theory or a hypothesis cannot sufficiently explain the mechanism of tinnitus. Thus, diverse theories and studies had been conducted to elucidate the secret of tinnitus. Degeneration of outer hair cell in the peripheral auditory system is known to be associated with tinnitus, while auditory plasticity theory, upregulation of excitation of central auditory structures explains the role of the central auditory pathway in the generation of tinnitus. In addition, somatosensory and limbic autonomic nervous systems are also deeply involved with the pathogenesis of tinnitus. Herein, recent pathophysiologic theories and remarkable studies of tinnitus were reviewed. Understanding of the mechanism of the tinnitus generation might be the cornerstone in the development of tinnitus treatment.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"25 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121261281","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.136
J. Lee, I. Moon
Tinnitus is a perception of sounds in the absence of external noise. Tinnitus can affect an individual’s life, prevent productive work or impair the quality of life. There are 2 types of tinnitus, objective and subjective, the latter being the most challenging of hearing disorders. Tinnitus has various forms and it can be difficult to relate a specific event with the appearance of tinnitus. Moreover, detection of tinnitus and evaluation of its severity is impossible. Therefore, treatment is usually based on the patient’s own assessment. To date, various forms of treatment have been administered with minimal success. Many different treatments have been attempted and then discontinued. The treatment goal of eliminating symptoms for severe tinnitus is rarely achieved. However, some symptoms of tinnitus can often be reduced to improve the patient’s quality of life allowing him or her to work despite residual effects of the disorder. In the present study we evaluated electrical stimulation, including transcranial direct current stimulation, transcranial magnetic stimulation for the treatment of tinnitus.
{"title":"Neuromodulation for the Treatment of Tinnitus","authors":"J. Lee, I. Moon","doi":"10.7599/HMR.2016.36.2.136","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.136","url":null,"abstract":"Tinnitus is a perception of sounds in the absence of external noise. Tinnitus can affect an individual’s life, prevent productive work or impair the quality of life. There are 2 types of tinnitus, objective and subjective, the latter being the most challenging of hearing disorders. Tinnitus has various forms and it can be difficult to relate a specific event with the appearance of tinnitus. Moreover, detection of tinnitus and evaluation of its severity is impossible. Therefore, treatment is usually based on the patient’s own assessment. To date, various forms of treatment have been administered with minimal success. Many different treatments have been attempted and then discontinued. The treatment goal of eliminating symptoms for severe tinnitus is rarely achieved. However, some symptoms of tinnitus can often be reduced to improve the patient’s quality of life allowing him or her to work despite residual effects of the disorder. In the present study we evaluated electrical stimulation, including transcranial direct current stimulation, transcranial magnetic stimulation for the treatment of tinnitus.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115899339","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.125
H. Shim
Corticosteroid administration has been widely used as the empirical treatment for various inner ear diseases such as sudden sensorineural hearing loss (SNHL), Meniere disease, and autoimmune-induced hearing loss for a long time. After Sakata et al. [1] first tried intratympanic (IT) steroid injection to control Meniere disease, IT steroid injection treatment has been used as an alternative option to systemic steroid treatment over the last two decades. Two major lines of evidence support the feasibility of IT steroid injection treatment and explaining its mechanism of action. First, injected steroid into the middle ear cavity can penetrate the round window membrane and diffuse into the inner ear fluid [2,3]. Second, many glucocorticoid receptors and mineralocorticoid receptors have been found in the inner ear structures [4-6]. Moreover, there is a theoretical advantage that IT steroid injection could increase the concentration into the target organ while it could also reduce the systemic steroid exposure; therefore the use of IT steroid injection has become widespread in a short time. Animal studies have demonstrted markedly higher concentration of corticosteroids in the endolymph and perilymph of the cochlea when delivered via the intratympanic route in comparison with systemic administration [3]. After these studies, a large-scale prospective study demonstrated IT-steroid injection treatment was not inferior to oral steroid treatment on sudden SNHL in humans [7]. Recent literature recommends IT-steroid injection not only as an alternative to oral steroid in vulnerable subjects such as diabetic patients, but also for a salvage therapy after failure of initial therapy [8,9].
{"title":"Intratympanic Steroid Injection in Tinnitus Management","authors":"H. Shim","doi":"10.7599/HMR.2016.36.2.125","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.125","url":null,"abstract":"Corticosteroid administration has been widely used as the empirical treatment for various inner ear diseases such as sudden sensorineural hearing loss (SNHL), Meniere disease, and autoimmune-induced hearing loss for a long time. After Sakata et al. [1] first tried intratympanic (IT) steroid injection to control Meniere disease, IT steroid injection treatment has been used as an alternative option to systemic steroid treatment over the last two decades. Two major lines of evidence support the feasibility of IT steroid injection treatment and explaining its mechanism of action. First, injected steroid into the middle ear cavity can penetrate the round window membrane and diffuse into the inner ear fluid [2,3]. Second, many glucocorticoid receptors and mineralocorticoid receptors have been found in the inner ear structures [4-6]. Moreover, there is a theoretical advantage that IT steroid injection could increase the concentration into the target organ while it could also reduce the systemic steroid exposure; therefore the use of IT steroid injection has become widespread in a short time. Animal studies have demonstrted markedly higher concentration of corticosteroids in the endolymph and perilymph of the cochlea when delivered via the intratympanic route in comparison with systemic administration [3]. After these studies, a large-scale prospective study demonstrated IT-steroid injection treatment was not inferior to oral steroid treatment on sudden SNHL in humans [7]. Recent literature recommends IT-steroid injection not only as an alternative to oral steroid in vulnerable subjects such as diabetic patients, but also for a salvage therapy after failure of initial therapy [8,9].","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121450653","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.86
Ja-Hee Kim, Hyo-Jeong Lee
{"title":"Functional Imaging of Tinnitus","authors":"Ja-Hee Kim, Hyo-Jeong Lee","doi":"10.7599/HMR.2016.36.2.86","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.86","url":null,"abstract":"","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123669632","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}
Pub Date : 2016-05-01DOI: 10.7599/HMR.2016.36.2.113
S. Park
Chronic subjective tinnitus is a prevalent symptom, not a disease in adults. Epidemiologic studies of general populations have estimated tinnitus prevalence at 10-15% of the adult population. Approximately 1-2% are severely affected and 0.5% are unable to lead a normal life [1-3]. Briefly, one in ten adults has clinically significant subjective tinnitus and one in hundred is severely affected. In addition, there is a high incidence of tinnitus associated with both noise-induced and age-related hearing loss [1]. Tinnitus-related distress interferes with quality of life in severe tinnitus sufferers, but the cure remains a challenging territory until now. The difficulties in the treatment of tinnitus lie in multiple etiologies, heterogeneous symptoms, limited understanding of the pathophysiology, and complicating psychological factors. Although the exact mechanisms should continue to be under active investigation, it is relatively well-known that the generation of tinnitus signal is associated with abnormal neuronal hyperactivity, synchrony, and reorganization in the central auditory pathways. However, all tinnitus signals would not cause persistent tinnitus perception unless the auditory system is pathologically linked to the brain regions responsible for emotions or consciousness. A comprehensive diagnostic assessment to identify the etiology and comorbidities is the basis of every successful tinnitus manageHanyang Med Rev 2016;36:113-119 http://dx.doi.org/10.7599/hmr.2016.36.2.113
慢性主观性耳鸣是一种普遍的症状，而不是成年人的疾病。一般人群的流行病学研究估计耳鸣患病率为10-15%的成年人。约有1-2%的患者受到严重影响，0.5%的患者无法正常生活[1-3]。简而言之，十分之一的成年人有临床上明显的主观性耳鸣，一百人中有一人受到严重影响。此外，耳鸣的高发与噪声性听力损失和年龄相关性听力损失有关[1]。耳鸣相关的痛苦会干扰严重耳鸣患者的生活质量，但直到现在，治疗仍然是一个具有挑战性的领域。耳鸣的病因多、症状异质、病理生理认识有限、心理因素复杂是耳鸣治疗的难点。虽然确切的机制还有待进一步研究，但耳鸣信号的产生与中枢听觉通路中异常的神经元过度活跃、同步和重组有关，这是相对众所周知的。然而，所有的耳鸣信号都不会引起持续的耳鸣感觉，除非听觉系统与负责情绪或意识的大脑区域有病理联系。全面的诊断评估，以确定病因和合并症是每一个成功的耳鸣管理的基础[j] yang Med Rev 2016;36:113-119 http://dx.doi.org/10.7599/hmr.2016.36.2.113
{"title":"Pharmacological Treatments for Tinnitus","authors":"S. Park","doi":"10.7599/HMR.2016.36.2.113","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.2.113","url":null,"abstract":"Chronic subjective tinnitus is a prevalent symptom, not a disease in adults. Epidemiologic studies of general populations have estimated tinnitus prevalence at 10-15% of the adult population. Approximately 1-2% are severely affected and 0.5% are unable to lead a normal life [1-3]. Briefly, one in ten adults has clinically significant subjective tinnitus and one in hundred is severely affected. In addition, there is a high incidence of tinnitus associated with both noise-induced and age-related hearing loss [1]. Tinnitus-related distress interferes with quality of life in severe tinnitus sufferers, but the cure remains a challenging territory until now. The difficulties in the treatment of tinnitus lie in multiple etiologies, heterogeneous symptoms, limited understanding of the pathophysiology, and complicating psychological factors. Although the exact mechanisms should continue to be under active investigation, it is relatively well-known that the generation of tinnitus signal is associated with abnormal neuronal hyperactivity, synchrony, and reorganization in the central auditory pathways. However, all tinnitus signals would not cause persistent tinnitus perception unless the auditory system is pathologically linked to the brain regions responsible for emotions or consciousness. A comprehensive diagnostic assessment to identify the etiology and comorbidities is the basis of every successful tinnitus manageHanyang Med Rev 2016;36:113-119 http://dx.doi.org/10.7599/hmr.2016.36.2.113","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122112738","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}
Pub Date : 2016-02-01DOI: 10.7599/HMR.2016.36.1.11
H. Ryu, Garam Han
Asperger syndrome (AS), also known as Asperger’s syndrome (AS), is an autism spectrum disorder (ASD) that is characterized by significant deficiencies in social interaction and nonverbal communication, alongside restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative development of linguistic and cognitive AS is believed to show relatively higher average intellectual abilities, and normative cognitive functioning. The diagnosis of AS was, however, eliminated in “the 2013 fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)” and replaced with a diagnosis of autism spectrum disorder on a severity scale [1-5]. People with AS may not be as withdrawn around others, compared to those with other, more debilitating forms of autism; they tend to approach others, even if awkwardly. For example, without understanding or recognizing the listener’s feelings such as hope to change the topic of a conversation or end the conversation, a person with AS may have a long-winded and one-sided speech about a favorite topic [6,7]. This social awkwardness has been called “active but odd” [8,9]. This failure to have appropriate social interaction may appear as disregard for the emotion of other people, and may come across as insensitive. Grandin (2009) thus newly suggested how to interact with technology for people with AS [10]. For instance, building upon that what most people with AS appreciated is structure in their environment, their daily routines, and their social interactions, many have an affinity with technology, governed by complex rules that might be predictable. More recently, other than how to intervene people with AS, designers tried to look at the possibility to include people with AS in their design process to create new innovative ideas. In so doing, they were interested in the special thinking style represented as the visual-dominant thinking style in the AS people. People with AS tend to think and memorize the world as relevant photos [11]. In a similar manner, although it is not a picture-like memory, some people with AS are fact thinkers having great memory capability of verbal facts [10]. Such difference in the thinking style is often considered as one of the reasons for the communication problems in society, but the designer sees this awkward thinking style as the driving force for developing new and innovative ideas. Hanyang Med Rev 2016;36:11-16 http://dx.doi.org/10.7599/hmr.2016.36.1.11 pISSN 1738-429X eISSN 2234-4446
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