Purpose: This study aimed to compare nurses’ perceptions of self-reported pain, the recorded pain score, and pain treatment according to the patient’s facial expression. Methods: In this descriptive cross-sectional survey, the participants were 482 nurses working at a tertiary hospital in Seoul, Korea. A self-report questionnaire presented nurses with a smiling patient complaining of acute post-surgical pain and a grimacing patient with cancer pain, both of whom reported a pain level of 8 out of 10, and asked nurses to indicate their perception of the pain intensity, the pain score that they would record, and the medication that they would provide for each patient. Results: The pain intensity perceived by nurses for the grimacing patient was significantly higher than that for the smiling patient (P<0.001). The recorded pain score was likewise significantly higher for the grimacing patient than for the smiling patient (P<0.001). There was a significant difference in the amount of morphine chosen by the nurses for pain interventions between the smiling and grimacing patients (P=0.040). Higher perceived pain intensity and score were associated with higher administered doses of morphine. Conclusion These findings suggest that nurses might be affected by patients’ facial expressions when treating pain. A pain management program should be developed that trains nurses to accurately recognize pain hidden in patients’ faces and provides them with the knowledge of how to appropriately assess and manage patients’ pain.

This study assessed the effects of soy isoflavones supplementation with exercise on urinary mineral (calcium, magnesium, copper, zinc) excretion as an index of bone resorption rates in 67 postmenopausal women. A total subjects were assigned to Isoflavone (90 mg/day) or placebo groups. These groups were further divided into groups that undergone a regular exercise or a rather sedentary state performing daily activity only. We conducted study eight week period. Result showed urinary zinc excretion was more significantly decreased in the isoflavone-sedentary group (-180.76 +/- 171.30 ug/day) than in the placebo-sedentary group (-31.23 +/- 146.60 ug/day), placebo-exercise group (40.93 +/- 193.44 ug/day) and isoflavione-exercise group (-1.21 +/- 160.61 ug/day) (p < 0.05), but no significant changes in the differences between the values of the pre and post study values in urinary calcium, magnesium and copper excretion. These results suggest that Isoflavone supplementation decrease urinary zinc excretion rate in postmenopausal subjects.
Bone Resorption ; Calcium ; Copper ; Female ; Humans ; Isoflavones ; Magnesium ; Zinc

In this comprehensive review, we discuss recent updates on tinnitus evaluation and treatment. Tinnitus evaluation commences with comprehensive medical history taking and audiological evaluation, which can provide valuable insight into the nature and extent of auditory disturbances. Additionally, tinnitus evaluation includes investigation of psychosomatic comorbidities to determine the intricate interplay between psychological factors and tinnitus perception. Various therapeutic approaches are available to minimize the burden of tinnitus. Cognitive behavioral therapy reshapes negative thought patterns and behaviors that are closely associated with tinnitus-induced distress. Acceptance and commitment therapy fosters mindfulness and value-aligned actions to address emotional effects. Tinnitus retraining therapy combines counseling and sound therapy for habituation. Tailor-made notched music therapy offers customized auditory experiences for symptom relief. Hearing aids and cochlear implants compensate for hearing loss and associated stress. Both neuromodulation and neurofeedback may be potentially useful. The role of pharmacotherapy and dietary supplements remains uncertain. Physiotherapy and head-neck manipulation relieve tinnitus associated with orofacial factors. Virtual reality, smartphone applications, and photobiomodulation may serve as novel therapeutic avenues. Although promising interventions are available, further research is warranted to confirm their effectiveness and long-term effects.

OBJECTIVES: To determine the diagnostic performance of transrectal ultrasound in virgin patients with polycystic ovary syndrome (PCOS) by receiver operating characteristic (ROC) curve analysis, compared with conventional transvaginal ultrasound assessment. METHODS: Ultrasound examinations were performed in 963 Korean women, with transvaginal transducers in 677 women and transrectal transducers in 286 women at Ewha Womans University Mokdong Hospital. Transvaginal ultrasound examinations were performed in 494 normal control women and 183 PCOS patients according to National Institutes of Health (NIH) PCOS diagnostic criteria. In virgin patients, transrectal ultrasound examinations were performed in 141 normal control women and 145 PCOS patients. ROC curves were calculated for ovarian volume and follicle number. RESULTS: By transvaginal ultrasound examination, the ovarian volume showed an area under the ROC curve (AURC) of 0.838. An ovarian volume decision threshold > 7 cm3 had a sensitivity of 73.0% and a specificity of 84.2% for the diagnosis of PCOS. The follicle number showed an AURC of 0.886. A follicle number decision threshold > or = 9 had a sensitivity of 78.6% and a specificity of 87.2% for the diagnosis of PCOS. By transrectal ultrasound examination, the ovarian volume and the follicle number showed AURCs of 0.815 as same thresholds with a sensitivity of 67.2% and 66.4%, respectively and a specificity of 86.8% each. Ovarian volume and follicle number by transvaginal and transrectal ultrasound assessment had a high diagnostic power for PCOS screening. CONCLUSION: Transrectal ultrasound assessment is as effective as conventional transvaginal ultrasound for the detection of PCOS in virgin patients.
Diagnosis ; Female ; Humans ; Mass Screening ; National Institutes of Health (U.S.) ; Polycystic Ovary Syndrome* ; ROC Curve ; Sensitivity and Specificity ; Transducers ; Ultrasonography*

BACKGROUND: Recent studies indicate that light-emitting diodes (LED) may represent a novel and effective anti-aging light source for the skin. Among many candidate molecules known to control collagens, caveolin-1 (Cav-1) is known to play an inhibitory role in cutaneous collagen metabolism. OBJECTIVE: This study aimed to evaluate the effects of LED irradiation on the expression levels of Cav-1 and procollagens (proCOLs) in human dermal fibroblasts (HDFs). METHODS: Cultured HDFs were irradiated with 630 nm LED at different doses, and the mRNA and protein expression levels of Cav-1 and proCOLs I/III were analyzed. RESULTS: In LED-irradiated HDFs, mRNA and protein levels of Cav-1 were found to be down-regulated, whereas those of proCOLs I/III were up-regulated in a dose-dependent manner. A negative correlation between Cav-1 and proCOLs was verified in Cav-1 siRNA transfected HDFs. LED was moreover found to result in up-regulation of transforming growth factor (TGF)-beta1 and its receptors (TbetaRI, TbetaRII), SMAD1, and SMAD2 mRNA levels, indicating that LED may activate the TGF-1/TbetaR/SMAD pathway in HDFs. CONCLUSION: The anti-aging effects of 630 nm LED on human skin are likely mediated by up-regulation of proCOLs I/III and inhibition of Cav-1 expression levels in HDFs.
Caveolin 1* ; Collagen ; Fibroblasts* ; Humans ; Metabolism ; Procollagen* ; RNA, Messenger ; RNA, Small Interfering ; Skin ; Transforming Growth Factors ; Up-Regulation

OBJECTIVE: This study aimed to analyze the association of socioeconomic factors, acculturation, and body mass index (BMI) as the first large prospective cohort study to determine the state of health of Vietnamese-born migrant women residing in Korea. METHODS: Participants were Vietnamese marriage-based immigrant women living in Korea. Data (n=1,066) was collected during both periods of baseline (2006–2011) and follow-up (2012–2014) in 34 cities in Korea. RESULTS: The results show that acculturation stress is relatively low among participants. Current BMI showed a significant difference according to the current age, monthly family income, and psychophysical stress. Depending on age, education level, monthly family income, we identified a significant difference in the annual BMI change. In correlation analysis, current BMI was significantly associated with age at arrival, reading and writing in Korean language adaptation, and psychophysical stress. Annual BMI change was significantly associated with age at arrival and years since immigration. CONCLUSION: Our analysis revealed that acculturation measured by Acculturative Stress Scale for International Students had no association with current BMI or annual BMI change, but had an association with several socioeconomic statuses. This study had the advantage that subjects had a homogenous background of marriage-based immigrant women, so we could see the association of BMI and acculturation, without considering cofounding factors.
Acculturation ; Asian Continental Ancestry Group ; Body Mass Index ; Cohort Studies ; Education ; Emigrants and Immigrants ; Emigration and Immigration ; Female ; Follow-Up Studies ; Humans ; Korea ; Prospective Studies ; Social Class ; Socioeconomic Factors ; Transients and Migrants ; Women's Health ; Writing

To elucidate the effect of soy isoflavone supplementation and exercise on serum lipids in normolipidemic and mildly hyperlipidemic postmenopausal period, 54 women residing in Seoul area were recruited. The subjects were divided into 4 groups: control group (n = 13), isoflavone group (n = 14), exercise group (n = 14), isoflavone + exercise group (n = 13). The control group was given placebo capsules, isoflavone group was given soy isoflavone supplements (90 mg/day), exercise group was given placebo capsules and exercised 3 times/week, over 30 min/time, and isoflavone + exercise group took soy isoflavone supplement and exercised. The duration of study were 8 weeks. The average age of the subjects was 57.0 years, 56.0 years, 54.4 years, and 55.2 years, respectively. There were no significant differences among the four groups in terms of height, weight, and body mass index. There were no significant differences among the four groups in terms of serum, total cholesterol, HDL-cholesterol. But the subjects indicated a significant difference in serum LDL-cholesterol (110.5 mg/day in before versus 74.6 mg/day in after) in the isoflavone + exercise group at the levels of p < 0.05. In conclusion, the isoflavone supplementation and exercise may be helpful to decrease serum lipids of normolipidemic and mildly hyperlipidemic postmenopausal women.
Body Mass Index ; Capsules ; Cholesterol ; Female ; Humans ; Postmenopause ; Seoul

BACKGROUND/AIMS: Proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE) is a newly recognized form of eosinophilic esophagitis (EoE) that responds to PPI therapy. It remains unclear whether PPI-REE represents a subphenotype of gastroesophageal reflux disease, a subphenotype of EoE, or its own distinct entity. The aim was to evaluate the clinicopathologic features of PPI-REE. METHODS: Six patients were diagnosed with PPI-REE based on symptoms, endoscopic abnormalities, esophageal eosinophilia with > or =15 eosinophils/high-power field, and a response to PPI treatment. Symptoms and endoscopic and pathological findings were evaluated. RESULTS: The median follow-up duration was 12 months. Presenting symptoms included dysphagia, heartburn, chest pain, foreign body sensation, acid reflux, and sore throat. All patients had typical endoscopic findings of EoE such as esophageal rings, linear furrows, nodularity, and whitish plaques. Three patients had a concomitant allergic disorder, and one had reflux esophagitis. Four patients exhibited elevated serum IgE, and five had positive skin prick tests. All patients experienced symptomatic resolution within 4 weeks and histologic resolution within 8 weeks after starting PPI therapy. There was no symptomatic recurrence. CONCLUSIONS: PPI therapy induced rapid resolution of symptoms and eosinophil counts in patients with PPI-REE. Large-scale studies with long-term follow-up are warranted.
Adult ; Asian Continental Ancestry Group ; Chest Pain/etiology ; Deglutition Disorders/etiology ; Diagnosis, Differential ; Eosinophilic Esophagitis/complications/*drug therapy/*pathology ; Esophagus/pathology ; Female ; Follow-Up Studies ; Gastroesophageal Reflux/etiology ; Heartburn/etiology ; Humans ; Male ; Middle Aged ; Pharyngitis/etiology ; Phenotype ; Proton Pump Inhibitors/*therapeutic use ; Republic of Korea ; Retrospective Studies ; Sensation Disorders/etiology ; Treatment Outcome ; Young Adult

The purpose of this study was to evaluate on nutrient intake status and diet quality of middle and old aged vegetarian women in Korea. The research group was composed of vegetarian women (n = 91), all of them were Seven Day Adventists, who had been on vegetarian diets, over 20 yrs. Their anthropometric measurements, dietary intakes, and diet quality indices were compared to omnivores (n = 122). The average age of vegetarians and omnivores were 61.8 yrs and 60.3 yrs, respectively. The mean daily energy intakes of vegetarians and omnivores were 1428.8 kcal and 1424.5 kcal, respectively and there was no significant difference. The vegetarians consumed significantly lower intakes of protein (p<0.05), zinc (p<0.001) and vitamin B2 (p<0.05) compared to omnivores. In the diet quality, zinc and vitamin B2 nutrient adequacy ratio (NAR) of vegetarians were significantly lower than those of omnivores. Mean adequacy ratio (MAR) of vegetarians and omnivores were 0.80 and 0.77, respectively and there was no significant difference. The KDDS (Korean's Dietary Diversity Score) of vegetarians and omnivores were 3.7 and 4.0, respectively, and there was significant difference (p<0.01). The KDQI (Korean's Diet Quality Index) of vegetarians (1.5) was significantly lower than that (2.1) of omnivores (p<0.001). In conclusion, vegetarian women have low intake status of protein, zinc and vitamin B2, and partly low diet quality. Therefore it was needed that well planed diets to replace the nutrients supplied from excluded food groups in middle and old aged vegetarian women.
Diet* ; Diet, Vegetarian ; Female ; Humans ; Korea* ; Riboflavin ; Zinc

OBJECTIVES: The association between thyroid-related hormones and cognitive function has been controversial. The purpose of this study is to compare the levels of thyroid-related hormones in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Furthermore, we investigated the relationship between thyroid-related hormones and cognitive function. METHODS: From January 2011 to December 2018, we retrospectively reviewed 105 patients who were diagnosed with AD and MCI by visiting a dementia clinic at Ilsan Paik Hospital. Thyroid-related hormones [triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH)] was measured using chemiluminescent immunoassay. An independent sample t-test was performed to analyze the mean value of thyroid-related hormones in patients of AD and MCI. To investigate whether thyroid-related hormones correlate significantly with Global deterioration scale (GDS), Clinical dementia rating (CDR) and scores of each The Korean version of the consortium to establish a registry for Alzheimer's disease items, we conducted a partial correlation analysis with geriatric depression scale-Korean version (GDS-K) scores as covariates. RESULTS: There was no significant difference in the mean serum T3, T4 and TSH levels between patients of the AD and the MCI, but the Construction Praxis Test (CPT) showed a significant positive correlation with the serum TSH concentration (p-value=0.004). CONCLUSIONS: In our study, the positive correlation between serum TSH level and the CPT associated with executive function was found to be helpful in understanding the association between thyroid-related hormones and the pathophysiology of dementia. Prospective studies in regard of the pathophysiology of thyroid-related hormones on cognitive function will be necessary in the future.
Alzheimer Disease ; Cognition ; Dementia ; Depression ; Executive Function ; Humans ; Immunoassay ; Mild Cognitive Impairment ; Prospective Studies ; Retrospective Studies ; Thyroid Hormones ; Thyrotropin ; Thyroxine