PURPOSE: The purpose of this study was to identify associated factors of chewing discomfort among community-dwelling elderly. METHODS: The study was cross-sectional design and secondary data analysis using the 6th Korea National Health and Nutrition Examination Survey. Among the total of 7,550 participants, data was analyzed with 1,126 adults aged 65 years and over. Chewing discomfort was assessed by the perceived chewing discomfort. Multivariate logistic regression analysis was used to find the associated factors of chewing discomfort. RESULTS: Along with 61.7% of the participants reported having chewing discomfort, 85.2% reported to perceive poor oral health and 35.0% had oral pain. In multivariate logistic regression, perceived oral health (OR 3.22, 95% CI 2.24~4.63), oral pain (OR 2.46, 95% CI 1.76~3.43), activity limitation (OR 1.71, 95% CI 1.05~2.80), teeth requiring treatment (OR 1.61, 95% CI 1.14~2.26), number of remaining teeth (OR 1.60, 95% CI 1.22~2.10) and educational level (OR 1.56, 95% CI 1.15~2.12) were the significant predictors of chewing discomfort. CONCLUSION: The prevalence in chewing discomfort was high in elderly Koreans and various factors were associated with chewing discomfort. To improve chewing ability, it is suggested that the national level of policies offer strategical oral health programs in this population.
Adult ; Aged* ; Humans ; Korea ; Logistic Models ; Mastication* ; Nutrition Surveys ; Oral Health ; Prevalence ; Statistics as Topic ; Tooth

A 49-year-old woman with anemia who developed headache and seizure after blood transfusion was diagnosed with posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging showed typical PRES findings including lesions in bilateral parieto-occipital subcortical white matter and overlying cortex. Only a few cases of PRES after transfusion have been reported and this case is unique in that there was a latent period between infusion and development of PRES. We postulate that rapid change of hemoglobin level may disrupt cerebral autoregulation and result in delayed PRES. We suggest that neurological symptoms after blood transfusion should be appropriately investigated.

Native valve endocarditis (NVE) without preexisting structural valve or congenital cardiac malformation especially in pediatric group is rare. A case of isolated tricuspid valve endocarditis in a 7-year-old child without any cardiac malformation is described. This child had suffered from fever and productive cough for 3 weeks. Blood culture grew Staphylococcus aureus. Fever was not controlled even with proper antibiotic treatment. Transthoracic echocardiogram and lung perfusion scan revealed a large vegetation on the tricuspid valve with multiple embolism Surgical procedures included vegetectomy partial cusps resection and pericardial patch valvuloplasty. Th patient was in NYHA class I during follow up.
Child ; Cough ; Embolism ; Endocarditis* ; Endocarditis, Bacterial ; Fever ; Follow-Up Studies ; Humans ; Lung ; Perfusion ; Staphylococcus aureus ; Tricuspid Valve*

No abstract available.
Leiomyosarcoma* ; Rectum*

OBJECTIVES: The aims of this study were to find and compare the effect of directional (DIR) processing of two different hearing aids via both subjective and objective methods, to determine the association between the results of the subjective and objective evaluations, and to find out individual predictive factors influencing the DIR benefit. METHODS: Twenty-six hearing aid users fitted unilaterally with each two different experimental hearing aid performed modified Korean Hearing in Noise Test (K-HINT) in three DIR conditions; omnidirectional (OMNI) mode, OMNI plus noise reduction feature, fixed DIR mode. In order to determine benefits from DIR benefit within a hearing aid and compare performance of the DIR processing between hearing aids, a subjective questionnaire was administrated on speech quality (SQ) and discomfort in noise (DN) domain. Correlation analysis of factors influencing DIR benefit was accomplished. RESULTS: Benefits from switching OMNI mode to DIR mode within both hearing aids in K-HINT were about 2.8 (standard deviation, 3.5) and 2.1 dB SNR (signal to ratio; SD, 2.5), but significant difference in K-HINT results between OMNI and OMNI plus noise reduction algorithm was not shown. The subjective evaluation resulted in the better SQ and DN scores in DIR mode than those in OMNI mode. However, the difference of scores on both SQ and DN between the two hearing aids with DIR mode was not statistically significant. Any individual factors did not significantly affect subjective and objective DIR benefits. CONCLUSION: DIR benefit was found not only in the objective measurement performed in the laboratory but also in the subjective questionnaires, but the subjective results was failed to have significant correlation with the DIR benefit obtained in the K-HINT. Factors influencing individual variation in perceptual DIR benefit were still hard to explain.
Hearing Aids* ; Hearing Loss ; Hearing* ; Noise ; Signal-To-Noise Ratio ; Speech Intelligibility

BACKGROUND: Stress has been recognized as a risk factor to various disorders including peptic ulcer disease. Life events are universal which everybody experiences. This study was done to find out whether stressful life events have a role in the development and exacerbation of peptic ulcer disease (PUD) and non-ulcer dyspepsia(NUD) comparing Lee's life stress scale between patients with gastroscopically proven PUD and NUD and those of control. METHODS: On hundred twenty two patients with PUD were studied at our institution from February 1, 1997 to June 30, 1997. Patients who experienced abdominal discomfort and found to have normal or chronic superficial gastritis by gastroscopic exam during the same period were selected for NUD group. Controls were selected from asymptomatic individuals who underwent upper gastrointestinal series procedure for a health screening. Stressful life events investigated were total, positive, and negative stresses measured by Lee's life stress scale(98 items), marital status, level of education, income, occupation, religion, history of cigarette smoking, and the amount of alcoholic consumption and were compared between the three groups. The data were analyzed by one way ANOVA and chi-square test. RESULTS: No statistically significant difference was found in total, positive, and negative stress scores between PUD group and NUD group, although they were significantly higher in PUD and NUD groups than those of the control group(p<0.05). Also statistically significant difference in income and occupation, tests and school, problems associated children and familial conflict were found between PUD group and the control group(p<0.05), as well as between NUD group and the control group(p<0.05). CONCLUSION: Stressful life events were associated with development of PUD and NUD.
Alcoholics ; Child ; Dyspepsia* ; Education ; Gastritis ; Humans ; Marital Status ; Mass Screening ; Occupations ; Peptic Ulcer* ; Risk Factors ; Smoking ; Stress, Psychological ; Ulcer*

Angiomyofibroblastoma is a distinctive, hitherto uncharacterized, benign soft tissue tumor of the vulva with histology similar to an aggressive pelvic angiomyxoma. It can be distinguished from an aggressive angiomyxoma by its circumscribed borders, higher cellularity, more numerous blood vessels, the frequent presence of plump stromal cells, minimal stromal mucin, and rarity of erythrocyte extravasation. We experienced a case of angiomyofibroblastoma of the vulva occurring in a 45-year-old woman. The lesion was a well-defined but not encapsulated mass, 4.5x4.2 cm. Histologically the mass was characterized by alternating hypercellular and hypocellular edematous zones in which abundant blood vessels were irregularly distributed. Immunohistochemically, the spindled, plump spindled, and oval stromal cells were reactive for vimentin and desmin, but not for cytokeratin, or S-100 protein.
Female ; Humans

Mitochondrial myopathy is characterized by variable clinical manifestations from mild limb weakness to fatal respiratory failure and central nervous system sequela. But it is a rare event that sleep disordered breathing become a clue of diagnosis for mitochondrial myopathy. We report a case of a 21 year-old man who was diagnosed as mitochondrial myopathy during the investigation for the possible cause of chronic hypoventilation syndrome. Before being admitted to our hospital, he was suspected as having sleep apnea syndrome in another hospital. We re-evaluated the history, physical examination, laboratoy findings and polysomnography in detail. Severe hypoxemia was noted during REM sleep on nocturnal polysomnography and the diagnosis of mitochondrial myopathy was made by muscle biopsy in rectus abdominis muscle. We treated him with bilevel positive airway pressure therapy during sleep and it could reverse the hypoxemia during REM sleep. He could be discharged with improved condition and is being well with the use of this ventilatory assistance.
Anoxia* ; Biopsy ; Central Nervous System ; Diagnosis ; Extremities ; Humans ; Hypoventilation ; Mitochondrial Myopathies* ; Physical Examination ; Polysomnography ; Rectus Abdominis ; Respiratory Insufficiency ; Sleep Apnea Syndromes ; Sleep, REM* ; Young Adult

Ectopic pregnancy is a common medical problem that is difficult to diagnose and potentially may lead to significant mortality or morbidity. The incidence of ectopic pregnancy is definitely increasing due to the rise in pelvic inflammatory disease (PID), pelvic surgery, intrauterine device (IUD), and assisted reproductive technologies, such as in vitro fertilization and embryo transfer (IVF-ET). Combined ectopic gestations are much rare and their true incidence is unknown. Multiple ectopic gestations may occur in a variety of locations. The majority involve one or both fallopian tubes. We report a case of combined tubal and cervical pregnancies, and discuss their management.
Embryo Transfer ; Fallopian Tubes ; Female ; Fertilization in Vitro ; Incidence ; Intrauterine Devices ; Mortality ; Pelvic Inflammatory Disease ; Pregnancy* ; Pregnancy, Ectopic ; Reproductive Techniques, Assisted

Intramural esophageal dissection is a rare disorder that's characterized by a lengthy laceration between the mucosal and submucosal layers of the esophageal wall, and the esophageal wall is without perforation. The three different types of acute esophageal injury are a mucosal tear (Mallory-Weiss syndrome), full-thickness rupture (Boerhaave's syndrome) and intramural esophageal dissection. Most intramural esophageal dissections respond to conservative management with a very good prognosis. This rare condition should be considered in patients who present with acute chest pain, dysphagia or odynophagia, and particularly in the presence of a bleeding disorder or where there has been recent administration of antiplatelet medication, anticoagulants or thrombolytics to avoid inappropriate treatment with surgery. We present here a rare case of intramural dissection of the esophagus that occurred when the patient was taking antiplatelet medication.
Anticoagulants ; Chest Pain ; Deglutition Disorders ; Esophagus ; Hemorrhage ; Humans ; Lacerations ; Prognosis ; Rupture