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.

As of April 18, 2020, there have been a total of 10,653 confirmed cases and 232 deaths due to coronavirus disease 2019 (COVID-19) in Korea. The pathogen spread quickly, and the outbreak caused nationwide anxiety and shock. This study presented the anecdotal records that provided a detailed process of the multidisciplinary teamwork in mental health during the COVID-19 outbreak in the country. Psychosocial support is no less important than infection control during an epidemic, and collaboration and networking are at the core of disaster management. Thus, a multidisciplinary team of mental health professionals was immediately established and has collaborated effectively with its internal and external stakeholders for psychosocial support during the COVID-19 outbreak.

BACKGROUND AND OBJECTIVES: Burning mouth syndrome (BMS) is a poorly understood disease that is characterized by burning pain of the tongue without any identifiable organic disease. The pathophysiology of the disease has not been elucidated, and some kind of neuropathies are suspected to be involved. In this study, topical antifungals were prescribed to patients and the authors tried to evaluate its efficacy to BMS.SUBJECTS AND METHOD: 166 patients who had been diagnosed with burning mouth syndrome underwent topical antifungals treatment alone, and then follow-up at 2, 6, and 10 weeks of treatment. Effectiveness of treatment was evaluated by a 0-to-4 verbal rating scale. All enrolled patients had fungus culture in the oral cavity. RESULTS: A total of 103 patients responded to treatment, accounting for 62% of the patients. Of those, a total of 63 patients were positive for the fungal culture, which was about 38% of the patients. There was a statistically significant difference between the initial pain assessment and the pain assessment after 10 weeks in all patients. The rate of response to treatment was not significantly different when classified according to patients' characteristics and comorbidities. CONCLUSION The result of the study suggests that topical antifungals are useful for BMS and that it can be used in addition to the systemic medication without the burden of side effects. Additional well-designed studies should be followed to prove the effectiveness of topical antifungals and research on pathophysiology of the disease.

OBJECTIVE: Working memory impairments serve as prognostic factors for patients with schizophrenia. Working memory deficits are mainly associated with gray matter (GM) thickness and volume. We investigated the association between GM diffusivity and working memory in controls and individuals with schizophrenia. METHODS: T1 and diffusion tensor images of the brain, working memory task (letter number sequencing) scores, and the demographic data of 90 individuals with schizophrenia and 97 controls were collected from the SchizConnect database. T1 images were parcellated into the 68 GM Regions of Interest (ROI). Axial Diffusivity (AD), Fractional Anisotropy (FA), Radial Diffusivity (RD), and Trace (TR) were calculated for each of the ROIs. RESULTS: Compared to the controls, schizophrenia group showed significantly increased AD, RD, and TR in specific regions on the frontal, temporal, and anterior cingulate area. Moreover, working memory was negatively correlated with AD, RD, and TR in the lateral orbitofrontal, superior temporal, inferior temporal, and rostral anterior cingulate area on left hemisphere in the individuals with schizophrenia. CONCLUSION: These results demonstrated GM microstructural abnormalities in the frontal, temporal, and anterior cingulate regions of individuals with schizophrenia. Furthermore, these regional GM microstructural abnormalities suggest a neuropathological basis for the working memory deficits observed clinically in individuals with schizophrenia.
Anisotropy ; Brain ; Diffusion ; Diffusion Tensor Imaging ; Gray Matter ; Gyrus Cinguli ; Humans ; Memory, Short-Term ; Schizophrenia

PURPOSE: To evaluate value of image subtraction for identifying hepatocellular carcinoma (HCC) capsule on gadoxetic acid-enhanced MR images. MATERIALS AND METHODS: This study involved 108 patients at risk of HCC preoperatively examined using gadoxetic acid-enhanced MRI with hepatic resection between May 2015 and February 2017. We evaluated qualities of subtraction images and presence of capsular appearance on portal venous or transitional phases conventional and subtraction images. We assessed effect of capsular appearance on subtraction images on HCC. RESULTS: After excluding 1 patient who had treated by transarterial chemoembolization prior to surgery and 33 patients with unsatisfactory subtraction image qualities, 82 focal hepatic lesions (73 HCC, 5 non-HCC malignancies, and 4 benign) from 74 patients were analyzed. Regarding detection of capsules, sensitivity, accuracy, and area under the receiver operating characteristic curve (AUC) on subtraction images were significantly higher than those on conventional images (95.4%, 89.0%, and 0.80, respectively; p < 0.001), though specificities were same (64.7%). For diagnosis of HCC, sensitivity, accuracy, and AUC on subtraction images were significantly higher than on conventional images (82.2%, 79.3%, and 0.69, respectively; p = 0.011), though specificities were identical (55.6%). CONCLUSION Portal venous or transitional phase gadoxetic acid-enhanced MRI subtraction images could improve detection of HCC capsule.

Simple hepatic cysts are common benign liver lesions that usually have no malignant capability. They are generally asymptomatic and are often found incidentally by abdominal imaging procedures. Treatment becomes necessary, however, when huge hepatic cysts cause symptoms and develop complications, such as hemorrhage, adjacent organ damage, and infection. Several therapeutic options have been performed for symptomatic and huge cysts, including the aspiration of cystic fluid, infusion of various sclerosing agents, and surgical intervention. The optimal management of huge hepatic cysts is controversial and each option has its complications and limitations. This paper reports a case of a 66-year-old woman diagnosed with a simple hepatic cyst 2 years earlier, who was referred to hospital due to abdominal pain. The diagnosis was a huge hepatic cyst with symptoms by abdominal imaging studies. During the follow-up period, the huge cysts resolved spontaneously without treatment.
Abdominal Pain ; Aged ; Diagnosis ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Sclerosing Solutions

OBJECTIVE: Pharyngoesophageal stricture formation and dysphagia following total laryngectomy negatively affect quality of life and result in nutritional compromise that can be successfully managed with various techniques. This study was conducted to describe our experiences of office-based balloon dilatation by transnasal endoscopy, which can be performed by an otolaryngologist. METHOD: The present study investigated three patients who underwent transnasal endoscopy guided balloon dilatation of pharyngoesophageal stricture. The assessment was performed based on the number of procedures and recurrences, final subjective outcomes, and complications. RESULT: There were no post-procedural complications. In one patient, a scarric band was found after the procedure; therefore, steroids were injected into the stricture site. There were 2–3 balloon dilatations and the interval between dilatations was 3–6 months. All patients were able to tolerate solid diet after 2 or 3 sessions. CONCLUSION: Transnasal endoscopic balloon dilatation, which can be easily performed by an otolaryngologist in an office setting without sedation or general anesthesia, can be a useful modality for treating pharyngoesophageal stricture after total laryngectomy.
Anesthesia, General ; Constriction, Pathologic ; Deglutition Disorders ; Diet ; Dilatation ; Endoscopy ; Humans ; Laryngectomy ; Methods ; Quality of Life ; Recurrence ; Steroids

A national nutrition surveillance system is an essential instrument for the detection of nutrition and nutrition-related health problems that can assist on policy implementation. The role of nutritional surveillance in detecting trends of nutritional problems and predicting their risks has become more important as its strong scientifically based method and evidences may provide insights on chronic disease risks. In this review, we attempted to identify dietary issues of Korean cardiometabolic disease (CMD) based on the national nutrition surveillance system and addressed gaps and limitations in the system. In addition, an alternative way on how the system can overcome these problems with the view of ultimately improving public health in Korea was discussed.
Chronic Disease ; Korea* ; Methods ; Nutrition Policy ; Public Health

Hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow tract (LVOT) obstruction (those with a gradient of > 100 mm Hg) are at the highest risk of hemodynamic deterioration during pregnancy. Complications of HOCM include sudden cardiac death, heart failure, and arrhythmias. Physiological changes during pregnancy may induce these complications, affecting maternal and fetal health conditions. Therefore, close monitoring with appropriate management is essential for the well-being of both mother and fetus. We report on the case of a 27-year-old female patient with severe LVOT obstruction HOCM, pressure gradient (PG) of 125 mm Hg at resting, and 152 mm Hg induced by the Valsalva maneuver at 34 weeks gestation. This case showed how close monitoring using echocardiography and proper management during the course of pregnancy resulted in successful delivery in the patient with extremely high PG HOCM.
Adult ; Arrhythmias, Cardiac ; Cardiomyopathy, Hypertrophic* ; Death, Sudden, Cardiac ; Echocardiography ; Female ; Fetus ; Heart Failure ; Hemodynamics ; Humans ; Mothers ; Pregnancy* ; Pregnancy, High-Risk ; Valsalva Maneuver ; Ventricular Outflow Obstruction

Pure red cell aplasia (PRCA) is a rare hematological disorder characterized by severe normochromic normocytic anemia and reticulocytopenia due to erythroid progenitor depletion in an otherwise normal bone marrow. Autoimmune hemolytic anemia (AIHA) is caused by autoantibodies directed against red blood cells with normocytic or macrocytic anemia with reticulocytosis. Both diseases can develop in conjunction with various underlying diseases, such as immunological disorders. Although rare, there have been a few cases of AIHA followed by PRCA. Here, we report a patient who developed PRCA following AIHA and was later diagnosed with systemic lupus erythematosus.
Anemia ; Anemia, Hemolytic, Autoimmune* ; Anemia, Macrocytic ; Autoantibodies ; Bone Marrow ; Erythrocytes ; Humans ; Lupus Erythematosus, Systemic* ; Red-Cell Aplasia, Pure* ; Reticulocytosis