Purpose: Tinnitus, which is often described as the conscious awareness of a sound without an external auditory stimulus, is one of the most common symptoms in the general population. This study aimed to explore the experiences of individuals living with tinnitus. Methods: In this qualitative exploratory study, data were collected from November 2017 to January 2018 through in-depth individual interviews with 11 tinnitus patients. Verbatim transcripts and field notes were analyzed using content analysis. Results: The extracted content was classified into three core categories of tinnitus experiences: “suffering from constant sound,” “being imprisoned surrounded by persistent noise,” and “efforts to overcome.” Conclusion This study shows that tinnitus had a severe negative impact on patients’ lives. The finding will help healthcare providers understand their patients more deeply.

OBJECTIVES: The aim of this study was to investigate continuously on how a short-term family psychoeducation program for schizophrenia would change the emotional stress and the knowledge of the family members. METHODS: Subjects were the family members who participated in the short-term family psychoeducation program for schizophrenia. The participants were asked to fill out self-reporting forms for 3 times-before commencing the 6-week family education, immediately after completing the program, and 3 months after completing the program respectively. RESULTS: A total of 46 subjects participated, and 20 of them responded to all questionnaires. Three months after the completion of psychoeducation, depression and anxiety subscale score among the General Health Questionnaire-28 decreased by 2.60 (p=0.04) and 2.20 (p=0.04) respectively. In caregiver burden criterion, the score decreased by 9.45 (p=0.04) in 3 months after completing the education. In knowledge about schizophrenia test, the score increased by 2.60 score (p<0.001), and this result was maintained after 3 months. CONCLUSION: It was found that a short-term family education program for schizophrenia was effective not only in improving the knowledge on the disease but also in reducing anxiety and depression, and this effect was maintained immediately after the psychoeducation and so was it as time passed as well.
Anxiety ; Caregivers ; Depression ; Education ; Humans ; Surveys and Questionnaires ; Schizophrenia* ; Stress, Psychological

Primary ciliary dyskinesia is a disease characterized by unexplained neonatal respiratory distress, otitis media, chronic sinusitis, and chronic bronchiectasis. In approximately half of cases, situs inversus totalis or other laterality defects are found. The incidence ranges from 1 in 4,000 to 1 in 40,000 live births. Early diagnosis is important and the disease is finally confirmed by electron microscopic biopsy. The treatment of primary ciliary dyskinesia is based on appropriate procedures. We present a rare case of a 20-year-old male with bronchiectasis, chronic otitis media and chronic sinusitis.
Biopsy ; Bronchiectasis ; Early Diagnosis ; Humans ; Incidence ; Kartagener Syndrome* ; Live Birth ; Male ; Otitis Media ; Sinusitis ; Situs Inversus ; Young Adult

Thrombotic thrombocytopenic purpura (TTP) is a clinical syndrome characterized by micro-angiopathic hemolytic anemia, thrombocytopenia, fever, renal disorders, and neurological manifestations. Its clinical course is rapid and the mortality rate is high if untreated or relapse occurs. Previous studies reported that rituximab, a monoclonal antibody for CD20 surface antigen on B lymphocytes, may be effective in treating idiopathic TTP that is refractory to plasma exchange or relapses after remission. A 27-year-old Vietnamese man presented with fever and fatigue starting 3 days earlier, which was diagnosed as idiopathic TTP. To overcome his poor responsiveness to combined therapy using steroids and plasma exchange, rituximab was considered. In the current case, the patient was treated with a lower dose of rituximab, instead of the conventional 375 mg/m2/week, and achieved successful remission.
Adult ; Anemia, Hemolytic ; Antigens, Surface ; Asian Continental Ancestry Group ; B-Lymphocytes ; Fatigue ; Fever ; Glucocorticoids ; Humans ; Mortality ; Neurologic Manifestations ; Plasma Exchange ; Plasma* ; Purpura, Thrombotic Thrombocytopenic* ; Recurrence ; Steroids ; Thrombocytopenia ; Thrombotic Microangiopathies ; Rituximab

Purpose: Circulating cell-free single-stranded DNA (ccf-ssDNA) is extracellular DNA and it is a useful biomarker for the diagnosis of tumors and predicting the prognosis of tumors. However, the clinical usefulness of ccf-ssDNA in colorectal cancer (CRC) is not well known. Thus, the purpose of this study was to investigate the clinical usefulness of ccf-ssDNA in CRC. Methods: The study was conducted on 44 patients who had undergone surgery for CRC, and ccf-ssDNA level was measured before surgery and statistical analysis was performed on clinical factors. Results: The association between ccf-ssDNA level and clinicopathological factors was analyzed and compared, and these factors included age, sex, body mass index, diabetes mellitus, hypertension, tumor markers (carcinoembryonic antigen and carbohydrate antigen 19-9), tumor location, size, stage (TNM), recurrence, and death. The group with a ccf-ssDNA level of ≥ 7.5 ng/μL had a lower age (P = 0.010), and was associated with diabetes mellitus (P = 0.037) and lymph node metastasis (P = 0.049). Multivariate analysis of disease-free survival showed that lymph node metastasis and ccf-ssDNA level (hazard ratio, 10.011; 95% confidence interval, 2.269–44.175; P = 0.002) were independent prognostic factors for recurrence. In terms of overall survival, there were no statistically significant results except for vascular invasion. Conclusion This study showed that ccf-ssDNA level in plasma in CRC patients was an independent prognostic factor that could predict recurrence non-invasively. In this regard, further evaluation with a prospective, large sample size study will be needed to obtain additional results.

Purpose: The metabolic activity and demand usually increase in seriously ill patients, especially in patients with a brain injury (BI). These nutritional demands have been traditionally satisfied using predictive equations (PEs). Recently, indirect calorimetry (IC) has been used widely because it is more accurate than other methods. This study measured the energy expenditures (EE) using IC (GE, CARESCAPE B650, Helsinki, Finland) and calculated the PEs simultaneously in patients with BI. Methods: This study was conducted on 55 patients with a BI for three years (2017.7∼2020.8), who were mechanically ventilated within a hospital for ≤seven days. The EE values using IC were measured once in each patient, and the EE values using PE were calculated using 5 PEs (ESPEN, Harris-Benedict, HB; Frankenfield, FK; Penn state, PS; and Faisy) at the same time.The 55 patients were divided into two groups, acute group (39 patients; ≤3 hospital days group, AG) and subacute group (16 patients; ＞3 hospital days group, SG) according to the time, and the values were obtained. Results: There were no differences in the patient’s characteristics between the two groups, including age, gender, severity of the condition (Simplified Acute Physiology Score II), and anthropometric parameters. In AG, the energy expenditure values using PEs were significantly lower than those using IC in the three PEs (IC 1,712.0±476 kcal, ESPEN 1,558.6±324 kcal, P=0.038, HB 1,582.4±273 kcal, P=0.037, PS 1,530.8±340 kcal, P=0.005). In SG, the EE value using PEs did not differ significantly from that using IC. Conclusion An accurate assessment of EE is critical for seriously ill patients. These results showed that the previously well-known PEs might not be correct, particularly in acute patients with BI. Therefore, it is recommended that the EE values be obtained using IC, at least in acute patients with BI.

Purpose: The metabolic activity and demand usually increase in seriously ill patients, especially in patients with a brain injury (BI). These nutritional demands have been traditionally satisfied using predictive equations (PEs). Recently, indirect calorimetry (IC) has been used widely because it is more accurate than other methods. This study measured the energy expenditures (EE) using IC (GE, CARESCAPE B650, Helsinki, Finland) and calculated the PEs simultaneously in patients with BI. Methods: This study was conducted on 55 patients with a BI for three years (2017.7∼2020.8), who were mechanically ventilated within a hospital for ≤seven days. The EE values using IC were measured once in each patient, and the EE values using PE were calculated using 5 PEs (ESPEN, Harris-Benedict, HB; Frankenfield, FK; Penn state, PS; and Faisy) at the same time.The 55 patients were divided into two groups, acute group (39 patients; ≤3 hospital days group, AG) and subacute group (16 patients; ＞3 hospital days group, SG) according to the time, and the values were obtained. Results: There were no differences in the patient’s characteristics between the two groups, including age, gender, severity of the condition (Simplified Acute Physiology Score II), and anthropometric parameters. In AG, the energy expenditure values using PEs were significantly lower than those using IC in the three PEs (IC 1,712.0±476 kcal, ESPEN 1,558.6±324 kcal, P=0.038, HB 1,582.4±273 kcal, P=0.037, PS 1,530.8±340 kcal, P=0.005). In SG, the EE value using PEs did not differ significantly from that using IC. Conclusion An accurate assessment of EE is critical for seriously ill patients. These results showed that the previously well-known PEs might not be correct, particularly in acute patients with BI. Therefore, it is recommended that the EE values be obtained using IC, at least in acute patients with BI.

This study aimed to identify maternal, infant, and perinatal mortality using the nationalpopulation data of South Korea between 2018 and 2020, and to analyze mortality rates according tocharacteristics such as age, date of death, and cause of death in each group. This study updates themost recent study using 2009 to 2017 data.Methods: Analyses of maternal, infant, and perinatal mortality were done with data identifiedthrough the supplementary investigation system for cases of death from the Census of PopulationDynamics data provided by Statistics Korea from 2018 to 2020.Results: Between 2018 and 2020, a total of 99 maternal deaths, 2,427 infant deaths, and 2,408 perinatal deaths were identified from 901,835 live births. The maternal mortality ratio was 11.3 deathsper 100,000 live births in 2018; it decreased to 9.9 in 2019 but increased again to 11.8 in 2020. Thematernal mortality ratio increased steeply in women over the age of 40 years. An increasing trend inthe maternal mortality ratio was found for complications related to the puerperium and hypertensive disorders. Both infant and perinatal mortality continued to decrease, from 2.8 deaths per 1,000live births in 2018 to 2.5 in 2020 and from 2.8 in 2018 to 2.5 in 2020, respectively.Conclusion: Overall, the maternal, infant, and perinatal mortality statistics showed improvements.However, more attention should be paid to women over 40 years of age and specific causes of maternal deaths, which should be taken into account in Korea’s maternal and child health policies.

Ischemic colitis is an inflammatory condition of the colon that results from insufficient blood supply commonly caused by enterocolitis, vessel occlusion, or shock. In contrast, pseudomembranous colitis is a clinical manifestation of Clostridioides difficile infection (CDI). Ischemic colitis caused by CDI has rarely been reported. Fecal microbiota transplantation (FMT) is an efficient treatment for refractory or fulminant CDI, and the indications for its use have recently expanded. However, performing FMT in patients with ischemic colitis is challenging because of the risk of perforation. Here, we have presented a case of ischemic colitis caused by CDI that was successfully treated with FMT via sigmoidoscopy.

Background: Low compliance (LC) with lifestyle modification is a very common obstacle in obesity management. The purpose of the current study was to investigate the effectiveness of obesity management according to compliance with a lifestyle-modification program. Methods: The “Change 10 Habits” program was administered four times over 12 weeks. Eighty-seven participants were divided into LC and high compliance (HC) groups for analysis after intervention. Then, to assess the program’s effectiveness based on compliance, we conducted t-tests and linear regression modeling. Results: In week 12, the scores of two dietary habits—specifically, “eat three meals regularly, adequate amount” and “do not eat after 9:00 PM”—were significantly higher in the HC group than in the LC group. Changes in leg and total body fat percentages were significantly improved in the HC group (−0.2%±0.3% vs. 0.9%±0.3%, P< 0.05; −0.1%±0.3% vs. 1.1%±0.5%, P<0.05, respectively). The body mass index was also significantly lower in the HC group than in the LC group (26.7±1.8 kg/m2 vs. 27.7±2.1 kg/m2 , P<0.05) at final follow-up. Finally, the systolic blood pressure, triglyceride, and very-low-density lipoprotein cholesterol values of the HC group also decreased significantly (from 117.9±12.2 to 114.3±15.0 mmHg, P<0.05; from 121.7±74.9 to 105.7±60.9 mg/dL, P<0.05; and from 24.3±15.0 to 21.1±12.2 mg/dL, P<0.05, respectively). Conclusion HC with the study program effectively improved the dietary habits, body fat composition, blood pressure, and lipid profile of adults with mild obesity.