No abstract available.
Ear Cartilage ; Ectropion ; Eyelids ; Transplants

BACKGROUND AND OBJECTIVES: Acceptable noise level (ANL) is a measure of the maximum background noise level (BNL) that a person is willing to tolerate while following a target story. Although researchers have used various sources of target sound in ANL measures, a limited type of background noise has been used. Extending the previous study of Gordon-Hickey & Moore (2007), the current study determined the effect of music genre and tempo on ANLs as possible factors affecting ANLs. We also investigated the relationships between individual ANLs and the familiarity of music samples and between music ANLs and subjective preference. SUBJECTS AND METHODS: Forty-one participants were seperated into two groups according to their ANLs, 29 low-ANL listeners and 12 high-ANL listeners. Using Korean ANL material, the individual ANLs were measured based on the listeners' most comfortable listening level and BNL. The ANLs were measured in six conditions, with different music tempo (fast, slow) and genre (K-pop, pop, classical) in a counterbalanced order. RESULTS: Overall, ANLs did not differ by the tempo of background music, but music genre significantly affected individual ANLs. We observed relatively higher ANLs with K-pop music and relatively lower ANLs with classical music. This tendency was similar in both low-ANL and high-ANL groups. However, the subjective ratings of music familiarity and preference affected ANLs differently for low-ANL and high-ANL groups. In contrast to the low-ANL listeners, the ANLs of the high-ANL listeners were significantly affected by music familiarity and preference. CONCLUSIONS: The genre of background music affected ANLs obtained using background music. The degree of music familiarity and preference appears to be associated with individual susceptibility to background music only for listeners who are greatly annoyed by background noise (high-ANL listeners).
Humans ; Music* ; Noise* ; Recognition (Psychology)

BACKGROUND: Although a growing number of guidelines and clinical researches are available for immunosuppressive treatment of post-transplantation, there is no clinical practice guideline for the care of kidney transplant recipients in Korea. Selection of a researchable question is the most important step in conducting qualified guideline development. Thus, we aimed to formulate key questions for Korean guideline to aid clinical decision-making for immunosuppressive treatment. METHODS: Based on previous published guidelines review, a first survey was constructed with 29 questions in the range of immunosuppressive treatments. The experts were asked to rate the clinical importance of the question using a 5-point Likert scale. The questions reached 60% or more from the first survey and additional new questions were included in the second survey. In analyzing the responses to items rated on the 9-point scale, consensus agreement on each question was defined as 75% or more of experts rating 7 to 9. RESULTS: In the first survey, 50 experts were included. Among the 29 questions, 27 were derived to get 60% or more importance and 3 new questions were additionally identified. Through the second survey, 9 questions were selected that experts reached consensus on 75% and over of the options. Finally, we developed key questions using PICO (patient, intervention, comparison, and outcome) methodology. CONCLUSION: The experts reached a high level of consensus on many of key questions in the survey. Final key questions provide direction for developing clinical practice guideline in the immunosuppressive treatment of transplantation.
Clinical Decision-Making ; Consensus ; Kidney Transplantation ; Kidney ; Korea ; Transplant Recipients

No abstract available.
Embolism ; Hyaluronic Acid ; Stroke ; Tissue Plasminogen Activator

No abstract available.
Dermatofibrosarcoma* ; Nose*

Background: and Objective: With the advancement of cancer treatments and increased life expectancy, managing breakthrough cancer pain (BTcP) is essential to improve the quality of life for cancer patients. This study aimed to compare the major rapid onset opioids in Korea based on their characteristics and costs to determine the best option for each patient. Methods: Based on sales information from IQVIA-MIDAS, sublingual fentanyl tablet (SLF), fentanyl buccal tablet (FBT), and oral transmucosal fentanyl citrate (OTFC) were selected as the top three drugs for the treatment of BTcP in Korea, considering them the most comparable drugs. The cost and cost-pain relief ratio of the drugs for short-term (1 month) and long-term (1 year) treatment were compared and the ease of administration based on various factors, including pharmacokinetics, onset of action, and administration procedures were evaluated. Results: SLF was evaluated as the best overall in terms of rapid onset of action, ease of administration, and drug cost and also had the highest market share. SLF had the lowest cost pain relief ratio for both the initial and supplemental treatment for the 1-month pain intensity difference 15 (PID15) ratio. However, for the 1-month PID30 ratio, SLF was not superior to OTFC or FBT. The longer the breakthrough cancer pain duration, the more cost-effective the other rapid onset opioids. Conclusion The rapid onset opioids that fit the patient’s breakthrough cancer pain pattern have the best cost-effectiveness.

Infants who are born between 24 hours and 1 year of age require extreme caution in their care due to their fragility. However, if there are multiple risk factors associated with the infant, caretaker, household, and surrounding circumstances, providing proper and appropriate care becomes problematic. This difficulty in caring for infants can contribute to abuse, neglect, or even death. This study investigates unexplained infant deaths that occur in the presence of multiple psychosocial risk factors. This study aimed to explore the relationship between various psychosocial risk factors and sudden, unexplained infant deaths. We examined nine cases from the autopsy archive of the National Forensic Service using a statistical approach. Among these cases, three were subject to legal action, while six were closed without further legal process. Although it was difficult to establish a clear relationship between death and abuse or neglect in the six cases, all were found to have experienced a harsh environment that was similar to abuse or neglect. We discuss the implications of our findings for understanding infant deaths and legal outcomes and propose a new framework to understand the deaths of infants.

BACKGROUND: Solar lentigines are the most common form of benign epidermal pigmentation and one of the major cosmetic concerns in Korea. A 532 nm Q-switched neodymium: yttrium-aluminum-garnet (QSND) laser is typically used for the treatment, but the occurrence of post-inflammatory hyperpigmentation (PIH) is not rare. Recently, the use of picosecond (PS) lasers has emerged in pursuit of better outcomes. OBJECTIVE: To objectively compare the efficacy and safety of 532 nm PS and QSND lasers for the treatment of solar lentigines. METHODS: Twenty patients with solar lentigines were enrolled in a prospective, randomized split-face, single-blind study. One side of each face was treated using a 532 nm PS laser, and the other side using a 532 nm QSND laser. After one treatment, all patients were followed up for evaluation after 2, 4, 8, and 12 weeks. The clinical clearance was assessed by three blinded dermatologists using a 5-point quartile improvement scale (QIS). Subjective satisfaction, development of PIH, pain scale during treatment, and adverse problems were also recorded. RESULTS: Clinical clearance measured by QIS showed that the PS laser was more effective than the QSND laser. Subjective satisfaction and pain scale did not significantly differ between the two groups. The incidence of PIH was 5% in sides treated with the PS laser, and 30% with the QSND laser. CONCLUSION Both 532 nm PS laser and QSND laser were effective for the treatment of solar lentigines, but the PS laser was more effective with less PIH development.

We compared the glycemic efficacy of treatment intensification between quadruple oral antidiabetic drug therapy and once-weekly glucagon-like peptide-1 receptor agonist (GLP-1RA)-based triple therapy in patients with poorly controlled type 2 diabetes mellitus refractory to triple oral therapy. For 24 weeks, changes in glycosylated hemoglobin (HbA1c) from baseline were compared between the two treatment groups. Of all 96 patients, 50 patients were treated with quadruple therapy, and 46 were treated with GLP-1RA therapy. Reductions in HbA1c for 24 weeks were comparable (in both, 1.1% reduction from baseline; P=0.59). Meanwhile, lower C-peptide level was associated with a lower glucose-lowering response of GLP-1RA therapy (R=0.3, P=0.04) but not with quadruple therapy (R=–0.13, P=0.40). HbA1c reduction by GLP-1RA therapy was inferior to that by quadruple therapy in the low C-peptide subgroup (mean, –0.1% vs. –1.3%; P=0.04). Treatment intensification by switching to quadruple oral therapy showed similar glucose-lowering efficacy to weekly GLP-1RA-based triple therapy. Meanwhile, the therapeutic response was affected by C-peptide levels in the GLP-1RA therapy group but not in the quadruple therapy group.

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26- 3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.