Results of a Government-supported Newborn Hearing Screening Pilot Project in the 17 Cities and Provinces from 2014 to 2018 in Korea

Background@#The aim of this study was to present and analyze, for the first time, the results of a government-supported nationwide newborn hearing screening (NHS) pilot project in the 17 major cities and provinces of Korea. @*Methods@#We analyzed a nationwide NHS database of 344,955 newborns in the pilot project from 2014 to 2018. The government supported the cost of one NHS and one diagnostic auditory brainstem response (ABR) test. Hearing loss (HL) was defined as ≥ 40 dB nHL on either side of the ABR threshold test. @*Results@#Most NHS tests were performed in the maternity clinics (91.5%). In regions with lack of maternity clinics, the screening rate of local clinics was high (Jeju: 31.1% and Sejong: 12.9%). In most regions, automated ABR was mainly used for screening test (89.7%), but Gangwon (32.7%), Jeju (31.0%), and Jeonbuk (29.6%) performed more NHS tests using (automated) otoacoustic emissions than other regions. The mean referral rate was 1.5%, but the overall diagnostic ABR rate was low at 18.5%. The referral rates of Busan (0.6%) and Gyeongnam (0.9%) were lower than 1%, and Jeju's referral rate was 7.3%. Prevalence of HL including unilateral HL was 0.12%. @*Conclusion@#Depending on the cities and provinces, there were significant differences in the screening rates and referral rates by hospital type and NHS method. For successful early hearing detection and intervention (EHDI) and quality control, it will be necessary to support and manage EHDI according to regional NHS's characteristics and ensure that the whole country conducts EHDI as standard.

Comparison of Newborn Hearing Screening Tests Depending on the Examiners in a General Hospital in a City / 農村醫學 地域保健

OBJECTIVES: To review the status of newborn hearing screening (NHS) and to investigate the effect of the examiners on NHS tests to help the quality control of NHS at a general hospital in a city. METHODS: The charts of newborns from January 2015 to March 2016 and from August 2016 to October 2017 were retrospectively reviewed. We compared the results of tests performed by several examiners(group 1) with those performed by one audiologist (group 2) using the same automated auditory brainstem response test. RESULTS: The screening rate and referral rate were not significantly different between group 1 and group 2. The confirmatory test rate was higher in the group 2, but it was not significant. In group 1, the number of tests performed 3 or more times in one ear at one time was significantly higher. The number of tests performed in only one ear at one time was higher in group 2. The screening rate within one month after birth was 64.21%, referral rate was 7.32%, confirmatory test rate within 3 months after birth was 21.74%, and the prevalence of hearing loss was 1.46%. CONCLUSIONS: There was no significant difference of results depending on the examiners. In order to make proper screening test, it is necessary to periodically educate the examiner and to instruct the examiner by the supervisor doctors.

Current status of newborn hearing screening in low-income families in the southeastern region of Korea / 한국역학회지

OBJECTIVES: The aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea. METHODS: This study analyzed data from the Ministry of Health and Welfare's project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015). RESULTS: The referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan. CONCLUSIONS: Hearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.

Current status of newborn hearing screening in low-income families in the southeastern region of Korea / 한국역학회지

OBJECTIVES@#The aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea.@*METHODS@#This study analyzed data from the Ministry of Health and Welfare's project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015).@*RESULTS@#The referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan.@*CONCLUSIONS@#Hearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.

Current status of newborn hearing screening in low-income families in the southeastern region of Korea / 한국역학회지

OBJECTIVES: The aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea.METHODS: This study analyzed data from the Ministry of Health and Welfare's project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015).RESULTS: The referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan.CONCLUSIONS: Hearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.

Prevalence of Allergic Rhinitis between Urban and Rural Residents in a Local Community / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to examine the prevalence of allergic rhinitis between urban areas in the adjacent areas to a steel industrial complex and rural areas and the impact of pollutants in the industrialized city on allergic rhinitis. METHODS: From July 28 to August 9 of 2008, 1,043 residents of urban and rural areas in a local community had enrolled in health screening and questionnaire survey. One thousand thirty-three patients also underwent a skin prick test. Prevalence rates of allergic rhinitis were calculated according to residential areas, and the used statistical analysis were Fisher's exact test and chi-square test. RESULTS: In a survey, the fraction of adults, who complained of sneezing, nasal obstruction and rhinorrhea, during a recent 1 year period, showed the significant difference between urban (30.5%) and rural areas (22.4%). The fractions of positive skin prick tests were not different between two areas in each age group. The prevalence of allergic rhinitis was 8.4% in urban areas and 6.9% in rural areas. Considering the age groups, the adults group only showed the significantly higher prevalence of allergic rhinitis in urban areas (8.2% vs. 3.7%). CONCLUSIONS: Unlike the children and adolescents groups, the prevalence of allergic rhinitis in adults group was higher in the industrialized urban areas.

Clinical Manifestation and Prognosis of Vestibular Migraine According to the Vestibular Function Test Results

BACKGROUND AND OBJECTIVES: According to previous reports, patients with vestibular migraine (VM) display variable results from vestibular function tests (VFT): central, peripheral, or normal. The aim of this study was to classify the VM patients into the three groups according to interictal VFT findings (central, peripheral or normal) and to clarify the relationship between VFT results and the clinical manifestations and prognosis in each group. SUBJECTS AND METHODS: We reviewed the medical records of 81 patients diagnosed as VM using the criteria of Neuhauser, et al. between December 2004 and June 2009. Patients were divided into three groups according to the results of VFT. We compared the clinical manifestations and prognosis between groups. Characteristics including dizziness, the nature of headache, associated otologic symptoms, hearing threshold, duration of illness, and recovery time were analyzed. RESULTS: The number of patients with central, peripheral vestibular dysfunction and normal finding in VFT were 15, 28, and 38 respectively. There were no significant differences in the nature of headache, associated otologic symptoms, hearing threshold, duration of illness, and recovery time. A small difference was observed in the mean age and characteristics of dizziness, but these were not significant. CONCLUSIONS: In patients with VM, classification according to the type of vestibular dysfunction was not helpful in the prediction of prognosis and clinical manifestations.

A Clinical Study on Alopecia Areata (1996-2000)(TGF-VI) / 대한피부과학회지

BACKGROUND: Alopecia areata patients has recently increased in number. The clinical features and therapeutic results of alopecia areata are diverse and unpredictable. OBJECTIVE: We, the authors, performed a study on alopecia areata in order to evaluate the clinical manifestations and compare the efficacies of treatment with intralesional injection of triamcinolone acetonide suspension, immunotherapy with diphenylcyclopropenone(DPCP), and photochemotherapy with psoralen plus UVA(PUVA). METHODS: A clinical study of 732 patients with alopecia areata including 33 cases of alopecia totalis and 46 cases of alopecia universalis was performed for 5 years, since March, 1996 to February, 2001 who visited to Alopecia Clinic at the Department of Dermatology, Collage of Medicine, Chung-Ang University. RESULTS: 1) The age distribution showed a peak incidence in the third decade(29.1%) and the mean age was 26.8 years and 136 cases(18.6%) showed alopecia areata in patients below 10 years old. 2) Previous episodes of alopecia were observed in 173 cases(23.6%) and 58 cases(7,9%) had family history of alopecia areata. 3) The most common site was the occipital region in both male and female patients, which were 251 cases(38.4%) and 218 cases(33.4%) respectively. 4) Associated diseases with alopecia areata included seborrheic dermatitis(97 cases), allergic contact dermatitis(25 cases), liver disease(22 cases), hypertension(18 cases), diabetes mellitus(16 cases), urticaria(16 cases), atopic dermatitis(14 cases) and thyroid disease(8 cases). 5) The efficacies of treatment modality had no statistical differences in DPCP immunotherapy, intralesional triamcinolone injection or photochemothrapy. CONCLUSION: There was no noticeable differences compared to previous studies on alopecia areata, except that increasing tendency of severe, recurrent, and refractory alopecia areata and number of chilclhood patients.

A Case of Internal Carotid Artery Traumatic Pseudoaneurysm with Epistaxis: Treated with Detachable Balloon Occlusion (DBO) and Detachable Coil / 대한이비인후과학회지

Traumatic pseudoaneurysm of the intracavernous internal carotid artery (ICA) is rare, but it is life threatening because of massive epistaxis. Unfortunately, the prompt diagnosis and treatment of this desease are frequently delayed due to its rarity and latent period. Optimal therapy for this diseases is essential in order to minimize its morbidity and mortality. The authors present a case of male patient with traumatic pseudoaneurysm of ICA. This patient was a 24-year-old male with a multiple facial bone fracture, with unilateral blindness and recurrent massive epistaxis after suffering a head trauma. Computed tomography, MRI and carotid artery angiogram showed intracavernous pseudoaneurysm. The patient was effectively treated with occlusion of the ICA circulation by endovascular treatment utilizing detachable balloon occlusion (DBO) and mechanically detachable tungsten coils.

Endoscopic Sinus Surgery of Antrochoanal Polyp / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Antrochoanal polyp usually appears as a large, soft, gelatinous mass in the nasopharynx. Most incidents of antrochoanal polyp arise from mucosa around the natural ostium of the maxillary sinus. Surgical methods employed in the treatment of antrochoanal polyp are simple avulsion, Caldwell-Luc's operation, osteoplastic maxillary sinus operation, inferior meatal antrostomy, as well as endoscopic removal. Simple avulsion has been known to accompany a high recurrence rate, whereas the incidence of recurrence has been reported to be lower for endoscopic sinus surgery. In this regard, we compared postoperative results of simple avulsion or Caldwell Luc's operation with endoscopic sinus surgery in treating antrochoanal polyp. MATERIALS AND METHODS: We evaluated 42 patients who were treated for antrochoanal polyp from April 1991 until April 1996 by analyzing their clinical features, radiologic findings, postoperative results, and postoperative complications. RESULTS: Simple avulsion method was used to treat 21 cases (50%), and endoscopic sinus surgery method was used to treat another 21 cases (50.0%, three cases were combined with Caldwell-Luc's operation). Among those who received simple avulsion treatment, 9 showed recurrence, whereas none of those who underwent endoscopic sinus surgery and were treated successfully showed recurrence. CONCLUSION: The results suggest that endoscopic sinus surgery is a successful surgical method for treating antrochoanal polyp.