Improving Accuracy and Reliability of Hearing Tests: An Exploration of International Standards

This study explores the internal standards for hearing tests and benefits of implementing international standard protocols, including the International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC), and discusses how ISO and IEC standards provide a framework for designing, calibrating, assessing hearing test instruments and methods, and exchanging and comparing data globally. ISO and IEC standards for hearing tests improve accuracy, reliability, and consistency of test results by applying standardized methods and environments. Moreover, they promote international harmonization and data interoperability, enabling information exchange and research collaboration. Those standards for hearing tests are beneficial but have challenges and limitations, such as variation in equipment and calibration, lag in updating standards, variation in implementation and compliance, and lack of coverage of clinical aspects, cultural diversity, and linguistic diversity. These affect the quality and interpretation of test results. Adapting ISO or IEC standards locally would improve their applicability and acceptability, while balancing customization and compatibility with global standards.

Noise and Room Acoustic Conditions in a Tertiary Referral Hospital, Seoul National University Hospital

BACKGROUND AND OBJECTIVES: Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital (SNUH) in Korea, are investigated. MATERIALS AND METHODS: Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured including examination rooms, operating rooms, nurse stations, receptions, and patient rooms. RESULTS: The A-weighted equivalent noise level, L(Aeq), ranges from 54 to 56 dBA, which is at least 10 dB lower than the noise levels of 65 to 73 dBA measured in American ERs. In an ICU, the noise level for the first night was 66 dBA, which came down to 56 dBA for the next day. The noise levels during three different ear surgeries vary from 57 to 62 dBA, depending on the use of surgical drills and suctions. The noise levels in a patient room is found to be 47 dBA, while the nurse stations and the receptions have high noise levels up to 64 dBA. The reverberation times in an operation room, examination room, and single patient room are found to be below 0.6 s. CONCLUSIONS: At SNUH, the nurse stations and receptions were found to be quite noisy. The ERs were quieter than in the previous studies. The measured reverberation times seemed low enough but some other nurse stations and examination rooms were not satisfactory according to the questionnaire.

Relationship between neuronal nitric oxide synthase and NADPH-diaphorase in the dorsal root ganglia during neuropathic pain / 대한마취과학회지

BACKGROUND: Changes in nitric oxide (NO) production in the dorsal root ganglia (DRG) may contribute to allodynia after nerve injury. It is known that the histochemistry of NADPH-diaphorase (NADPH-d) is known to be not always coincident with NOS. This study was conducted to investigate the relationship between nNOS and NADPH-d expression in the DRG in a spinal nerve injury model of neuropathic pain, and to elucidate role that NO plays in neuropathic pain. METHODS: nNOS immunohistochemistry and/or NADHP-d histochemistry were conducted in the DRG of a spinal nerve transection model of neuropathic pain, and the pain behavior was then measured by a von Frey filament test of the hindpaws of wild type and nNOS knock-out mice. RESULTS: nNOS immunoreactive neurons and NADPH-d stained neurons were not always identical. Additionally NADPH-d increased, but nNOS did not increase significantly in the DRG after spinal nerve transection. Neuropathic pain behavior increased in the hindpaw of nNOS(-/-) mice after spinal nerve transection, but was lower than that of wild type mice after spinal nerve transection. CONCLUSIONS: nNOS immunoreactive neurons and NADPH-d stained neurons were not always identical in the DRG, and a novel NADPH-d positive source may be involved in neuropathic pain after spinal nerve transection. Changes in nNOS expression in the DRG were not the primary cause of neuropathic pain behavior in a spinal nerve transection model of neuropathic pain.

The effect of intraoperative colloid solutions coadministered with 6% hydroxyethyl starch (130/0.4) on platelet function in patients undergoing total intravenous anesthesia / 대한마취과학회지

BACKGROUND: Colloid solutions are used to treat hypovolemia and expanding plasma, but they may inhibit platelet function and reduce the level of coagulation factors during surgery. This study was conducted to compare the effects of hydroxyethyl starch (HES) on adenosine diphosphate (ADP)- and collagen-induced platelet aggregation in patients undergoing total intravenous anesthesia. METHODS: Patients undergoing endoscopic sinus surgery under total intravenous anesthesia with propofol and remifentanil were divided into a group that underwent fluid management with only crystalloid solution (n = 15) and a group that was managed with crystalloid solution that included 6% HES (130/0.4) (n = 15). ADP- and collagen-induced platelet aggregation were measured 5 minutes before induction, after the first intraoperative hour, and one hour postoperatively. RESULTS: Significantly diminished ADP- and collagen-induced aggregation values were observed intraoperatively when compared with the preoperative value in the patients that were managed with colloid solution that included HES. In addition, significantly diminished collagen-induced aggregation values were observed intraoperatively when compared with the preoperative value in the group that was managed with the solution that only contained the crystalloid. However, ADP- and collagen-induced platelet aggregation were recovered postoperatively in both groups. CONCLUSIONS: The results of this study indicated that fluid therapy with colloid solution that contained 6% HES (130/0.4) may diminish ADP-induced platelet aggregation intraoperatively in patients subjected to total intravenous anesthesia.

Comparing the effects of esmolol and remifentanil on the cardiovascular and catecholamine response to endotracheal intubation during the induction of general anesthesia / 대한마취과학회지

BACKGROUND: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the effect of esmolol and remifentanil on the cardiovascular and catecholamine responses to endotracheal intubation. METHODS: Sixty ASA I and II patients were randomly allocated to three groups. Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.9 mg/kg and this was maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. The patients received 10 ml intravenous saline (control group), 1.5 mg/kg esmolol (esmolol group) or 1microgram/kg remifentanil followed by an infusion of 0.1microgram/kg/min (remifentanil group) before intubation. The noninvasive blood pressure and heart rate were recorded before induction (baseline), before intubation and at 1, 2, 3 and 5 minutes after intubation. The blood catecholamine level (epinephrine and norepinephrine) was measured before induction and at 1 and 5 minutes after intubation. RESULTS: The systolic, diastolic and mean arterial pressures after endotracheal intubation were similar in the control and esmolol groups, but they were lower in the remifentanil group (P 0.05). CONCLUSIONS: 1microgram/kg remifentanil followed by an infusion of 0.1microgram/kg/min is more effective than 1.5 mg/kg esmolol for inhibiting the cardiovascular responses following endotrachal intubation during the induction of general anesthesia.

Comparing the effects of esmolol and remifentanil on the cardiovascular and catecholamine response to endotracheal intubation during the induction of general anesthesia / 대한마취과학회지

BACKGROUND: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the effect of esmolol and remifentanil on the cardiovascular and catecholamine responses to endotracheal intubation. METHODS: Sixty ASA I and II patients were randomly allocated to three groups. Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.9 mg/kg and this was maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. The patients received 10 ml intravenous saline (control group), 1.5 mg/kg esmolol (esmolol group) or 1microgram/kg remifentanil followed by an infusion of 0.1microgram/kg/min (remifentanil group) before intubation. The noninvasive blood pressure and heart rate were recorded before induction (baseline), before intubation and at 1, 2, 3 and 5 minutes after intubation. The blood catecholamine level (epinephrine and norepinephrine) was measured before induction and at 1 and 5 minutes after intubation. RESULTS: The systolic, diastolic and mean arterial pressures after endotracheal intubation were similar in the control and esmolol groups, but they were lower in the remifentanil group (P 0.05). CONCLUSIONS: 1microgram/kg remifentanil followed by an infusion of 0.1microgram/kg/min is more effective than 1.5 mg/kg esmolol for inhibiting the cardiovascular responses following endotrachal intubation during the induction of general anesthesia.