Audiological Follow-up Results after Newborn Hearing Screening Program

ObjectivesTo investigate the validity of newborn hearing screening protocol using automated auditory brainstem response (AABR) with a confirmation method using click auditory brainstem response (ABR) and to evaluate changes in hearing status of infants with confirmed congenital hearing loss.MethodsNeonates in the well-baby nursery were screened by staged AABR. Subjects whose final AABR result was "refer" were tested by diagnostic click ABR and 226 Hz tympanometry within 3 months of age. Changes in hearing status of subjects with confirmed hearing loss were analyzed by follow-up ABR at 3-6 month intervals.ResultsOf the 12,193 healthy babies born during this period, 10,879 (89.22%) were screened by AABR. Of 10,879 neonates screened by AABR, 148 (1.36%) were "referred"; of these, 45 subjects showed ABR thresholds over 30 dB nHL in at least one ear. Thirty-four subjects underwent serial follow-up ABR tests, with 11 (32.4%) found to have normal ABR thresholds. Most subjects with mild to moderate hearing loss were found to be normal before 1 year of age, whereas all infants with severe or profound hearing loss were identified as having congenital hearing loss.ConclusionThe referral rate and the positive predictive value of our protocol were acceptable. We have also found here that substantial temporary hearing loss can be included in the first confirmative diagnosis. Temporary hearing loss of our study on follow-up give emphasis to need of further differentiation using the testing for bone conduction and middle ear status

Heterogeneous Relationship between Financial Literacy and Fund Investment Behaviors: Evidence from South Korea during the Financial Crisis

The importance of financial knowledge on efficient investment behaviors is well known. However, few studies have examined the relationship between financial literacy and investment behaviors under different economic situations. Using the 2007–2016 Fund Investors Survey from South Korea, we investigate the heterogeneous effects of financial literacy on individual investment decisions during and after the 2008 financial crisis. While differentiating objective and subjective financial knowledge, we find that only subjective knowledge is positively related to participation in financial markets and negatively related to fund exit decisions during the financial crisis (2007–2008). However, in the postcrisis period (2009–2016), both subjective and objective financial knowledge affect fund investment behaviors. We further examine these results through a knowledge calibration mechanism. We present suggestive evidence that the effect of subjective knowledge during the financial crisis is not driven by overconfident investors whose subjective knowledge level deviates from objective knowledge but by the group whose subjective and objective knowledge are highly calibrated

ATP and Nitric Oxide Modulate Intracellular Calcium in Isolated Pillar Cells of the Guinea Pig Cochlea

Supporting cells in the mammalian cochlea have recently received attention as potential targets of neurotransmitters, neuromodulators, and neurohumoral agents. Calcium homeostasis in Deiters' and Hensen's cells, for example, is regulated by ATP and nitric oxide. We studied the intracellular calcium concentration [Ca2+]i in isolated pillar cells of the guinea pig cochlea in response to extracellular ATP and nitric oxide using the fluorescent indicator fluo-3. [Ca2+]i increased rapidly and significantly throughout the pillar cell in response to a bolus of ATP or 2-methylthio ATP while a, b-methylene ATP was ineffective. The response to ATP was inhibited by suramin and Cibacron Blue but not by pyridoxal phosphate 6-azopheny1-2',4'-disulfonic acid. This pharmacological profile is consistent with a [Ca2+]i increase largely mediated by P2Y receptors. In Ca2+-free medium supplemented with EGTA, the response to extracellular ATP was reduced by 33%, suggesting a contribution of calcium influx to the overall effect. The ATP-induced increase of [Ca2+]i was attenuated by NO donors (sodium nitroprusside or diethylamine NONOate), and this attenuation was reversed by KT5823, an antagonist to protein kinase G. The results indicate the involvement of purinergic mechanisms and the nitric oxide/cyclic GMP/protein kinase G pathway in the regulation of [Ca2+]i in cochlear pillar cells.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42438/1/10162-2-4-399_10020399.pd

Comparison of the Clinical Results of Attic Cholesteatoma Treatment: Endoscopic Versus Microscopic Ear Surgery

Objectives We aimed to compare clinical outcomes including hearing improvement and cholesteatoma recurrence between endoscopic and conventional microscopic surgeries in patients with attic cholesteatoma. Methods We collected data from patients with attic cholesteatoma who were treated using endoscopic (10 patients) and microscopic (10 patients) approaches by a single surgeon. The data were retrospectively reviewed for patient characteristics, intraoperative findings, hearing levels, and follow-up clinical status. Recurrence of the cholesteatoma, improvement of hearing, and operation time were evaluated. Results Ossiculoplasty was performed in four patients in the endoscopic group and two patients in the microscopic group. Lempert endaural incision II was used in all the patients in the microscopic group, whereas Lempert I incision was used in all the patients in the endoscopic approach group. There were no significant differences between the two groups regarding hearing improvement and operating time. And, there were no recurrences during the follow-up period in both groups. Conclusion The endoscopic approach for the management of attic cholesteatoma is as useful as the microscopic approach

Short-Term Effects of Ginkgo biloba Extract on Peripapillary Retinal Blood Flow in Normal Tension Glaucoma

PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.ope

Clinical Comparison of the Auditory Steady-State Response with the Click Auditory Brainstem Response in Infants

ObjectivesOur goal was to determine the effectiveness of using the auditory steady state response (ASSR) as a measure of hearing thresholds in infants who are suspected of having significant hearing loss, as compared with using the click-auditory brainstem response (C-ABR).MethodsWe retrospectively analyzed the audiologic profiles of 76 infants (46 boys and 30 girls, a total of 151 ears) who ranged in age from 1 to 12 months (average age: 5.7 months). The auditory evaluations in 76 infants who were suspected of having hearing loss were done via the C-ABR and ASSR. In addition, for reference, the mean ASSR thresholds were compared to those of 39 ears of infants and 39 ears of adults with normal hearing at 0.5, 1, 2, and 4 kHz.ResultsThe highest correlation between the C-ABR and ASSR thresholds was observed at an average of 2-4 kHz (r=0.94). On comparison between the hearing of infants and adults at 0.5, 1, 2, and 4 kHz, the mean ASSR threshold in infants was 12, 7, 8, and 7 dB higher, respectively, than that in adults.ConclusionASSR testing may provide additional audiometric information for accurately predicting the hearing sensitivity, and this is essential for the management of infants with severe to profound hearing loss