No abstract available.

Tumarkin's otolithic crisis refers to drop attacks that are an unusual manifestation of Meniere's disease. It has been proposed that these drop attacks result from mechanical deformation of the otolithic organs related to the endolymphatic hydrops that occurs in Meniere's disease, as revealed by MRI with intratympanic gadolinium enhancement. Here we report a patient with Tumarkin's otolithic crisis in whom inner-ear MRI with intratympanic gadolinium administration during the acute attack did not reveal the presence of endolymphatic hydrops.
Endolymphatic Hydrops* ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Meniere Disease ; Otolithic Membrane* ; Syncope

PURPOSE: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. METHODS: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. RESULTS: The mean score for RSS was 17.80+/-9.16. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). CONCLUSION: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.
Adaptation, Psychological ; Adult ; Aged ; Critical Illness/*psychology ; Cross-Sectional Studies ; Female ; Humans ; *Intensive Care Units ; Male ; Middle Aged ; Patient Transfer ; Questionnaires ; Stress, Psychological/*etiology ; Syndrome

Purpose: This study aims to describe and identify in-depth the breastfeeding experience of primiparas for more than one year using a phenomenological research method and to raise the understanding of the primiparas’ subjective experiences during the breastfeeding process to contribute to the improving and maintaining maternal and child health. Methods: This research was a phenomenological and qualitative study conducted on 5 primiparas who continued breastfeeding for more than 12 months. Data was collected through individual in-depth interviews from November 1, 2021 to March 20, 2022, and it was analyzed through the sixth stage of phenomenological research analysis presented by Colaizzi. Results: The study consisted of 10 theme clusters and 26 themes from meaningful statements about the breastfeeding success experiences of primiparas for more than one year. The 10 theme collections were "Planning breastfeeding during pregnancy," "Commitment to breastfeeding through information and education," "Challenges faced during breastfeeding," "Continuous hard work," "Continued conflict over breastfeeding amid confusion," "Connects with experts who lead the way," "Establishes one's own standards and direction," "Peace after hard work," "Solid and firm confidence," and "Deep-rooted beliefs brestfeeding serve as reminders." Conclusion It is expected that this study will help to understand the individual difficulties and problems experienced by primiparas during breastfeeding, the importance of breastfeeding education, the role of medical personnel in the early stage of childbirth, social and environmental support, and the importance of an active window for information exchange. By identifying these factors, this study can serve as basic data for nursing practice to promote successful breastfeeding.

Purpose: Microinvasive breast cancer (MIBC) is an invasive carcinoma with a tumor dimension not exceeding 1 mm. Owing to its low incidence, the rate of axillary node metastasis and its management are not well established. The aim of this study was to assess the incidence of lymph node metastasis (LNM) and identify variables associated with LNM, as well as to evaluate the need for axillary staging in MIBC patients by analyzing nationwide data. Methods: The Korean Breast Cancer Society registry was searched to identify MIBC patients diagnosed between January 1996 and April 2020. Patients without neoadjuvant chemotherapy experiences, systemic metastasis, and missing or discordant data were eligible for the analysis. The incidence rate of LNM was determined, and variables associated with LNM were identified by multivariable regression analysis. Results: Of 2,427 MIBC patients identified, 98 (4.0%) had LNM and 12 (0.5%) had N2/3 disease. Type of breast operation (odds ratio [OR], 2.093; 95% confidence interval [CI], 1.332–3.290; P = 0.001), age (OR, 2.091; 95% CI, 1.326–3.298; P = 0.002), hormone receptor status (OR, 2.220; 95% CI, 1.372–3.594; P = 0.001), and lymphovascular invasion (OR, 11.143; 95% CI, 6.354–19.540; P < 0.001) were significantly related to LNM. Conclusion The incidence of LNM in MIBC patients was only 4.0% in our study, suggesting that de-escalation of axillary surgical interventions could be carefully considered. The indications for axillary staging should be individualized considering tumor volume, age, hormone receptor status, and lymphovascular invasion to improve the quality of life of MIBC survivors.

Metabolic alterations including postprandial hyperglycemia have been implicated in the development of obesity-related diseases. Xylose is a sucrase inhibitor suggested to suppress the postprandial glucose surge. The objectives of this study were to assess the inhibitory effects of two different concentrations of xylose on postprandial glucose and insulin responses and to evaluate its efficacy in the presence of other macronutrients. Randomized double-blind cross-over studies were conducted to examine the effect of D-xylose on postprandial glucose and insulin response following the oral glucose tolerance test (OGTT). In study 1, the overnight-fasted study subjects (n = 49) consumed a test sucrose solution (50 g sucrose in 130 ml water) containing 0, 5, or 7.5 g D-xylose powder. In study 2, the overnight-fasted study subjects (n = 50) consumed a test meal (50 g sucrose in a 60 g muffin and 200 ml sucrose-containing solution). The control meal provided 64.5 g of carbohydrates, 4.5 g of fat, and 10 g of protein. The xylose meal was identical to the control meal except 5 g of xylose was added to the muffin mix. In study 1, the 5 g xylose-containing solutions exhibited significantly lower area under the glucose curve (AUCg) and area under the insulin curve (AUCi) values for 0-15 min (P < 0.0001, P < 0.0001), 0-30 min (P < 0.0001, P < 0.0001), 0-45 min (P < 0.0001, P < 0.0001), 0-60 min (P < 0.0001, P < 0.0001), 0-90 min (P < 0.0001, P < 0.0001) and 0-120 min (P = 0.0071, P = 0.0016). In study 2, the test meal exhibited significantly lower AUCg and AUCi values for 0-15 min (P < 0.0001, P < 0.0001), 0-30 min (P < 0.0001, P < 0.0001), 0-45 min (P < 0.0001, P = 0.0005), 0-60 min (P = 0.0002, P = 0.0025), and 0-90 min (P = 0.0396, P = 0.0246). In conclusion, xylose showed an acute suppressive effect on the postprandial glucose and insulin surges.
Carbohydrates ; Cross-Over Studies ; Glucose ; Glucose Tolerance Test ; Hyperglycemia ; Insulin ; Meals ; Sucrase ; Sucrose ; Xylose

Vesicouterine fistula, a fistula between bladder and uterus, is one of the rarest urogenital fistula. Most cases are associated with repeat Cesarean section and with vaginal birth after Cesarean section (VBAC). During Cesarean section, it is important to dissect and move the bladder away from uterus carefully, especially in case of adherent bladder to the anterior vaginal wall or lower segment wall and it is necessary to explain the possibility of vesicouterine fistula development in case of VBAC. Patients usually present with urinary incontinence in the early postoperative period or present months or years later with cyclic hematuria, amenorrhea, vaginal leakage of urine, urinary tract infection and secondary infertility. The diagnosis is made by cystoscopic visualization of the fistula orifice in the bladder and outlining the fistula tract on cystogram, hysterosalpingogram or transvaginal ultrasonogram. There have been varied approaches to the treatment of vesicouterine fistula with conservative therapy or surgical therapy. We experienced two cases of vesicouterine fistulas in women with previous Cesarean section, the one is delivered with repeat Cesarean section after trying VBAC, the other is delivered with vacuum assisted VBAC, and treated with surgical repair.
Amenorrhea ; Cesarean Section* ; Cesarean Section, Repeat ; Diagnosis ; Female ; Fistula* ; Hematuria ; Humans ; Infertility ; Postoperative Period ; Pregnancy ; Ultrasonography ; Urinary Bladder ; Urinary Incontinence ; Urinary Tract Infections ; Uterus ; Vacuum ; Vaginal Birth after Cesarean

BACKGROUND: It is important to recognize the independent prognostic factors of papillary carcinoma of thyroid in therapeutic and follow up planning. However, its good prognosis and its low prevalence make it difficult to analyze prognostic factors determining patients survival in a relatively short period of time. We retrospectively investigated the independent prognostic factors for determining disease recurrence after surgery which, in adults, are known to be closely related to the prognosis of cancer. METHOD: We retrospectively reviewed the clinical records of 456 patients (male 70, female 381, unknown 5, mean age of 43.9+-12.9 years) who had visited the thyroid clinic in Seoul National University Hospital and analyzed the data with statistical software program. RESULTS: 1) At initial visit, chief complaint of the patients was abnormal neck mass in 90 percent. 2) In preoperative thyroid scan study, 82% showed cold area and 16% showed diffuse enlargement. 3) Of the 50 recurrent cases after surgery (11.5% of the total cases), 39 cases (78%) had recurred disease in neck area and 11 cases (22%) had recurrences at distant sites. (Lung 9 cases, Brain I case, Mediastinum 1case) 4) Statistically significant risk factors for recurrence after surgery were male sex, size of tumor (above 4.5cm in this study), extrathyroidal invasion of cancer, involvement of resection margin and no remnant ablation of thyroid tissue using radioiodine. CONCLUSION: Through retrospective study, we presented some clinical characteristics of papillary thyroid cancer in Korea and independent risk factors of cancer recurrences after surgery.
Adult ; Brain ; Carcinoma, Papillary ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Mediastinum ; Neck ; Prevalence ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Seoul ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: This study was designed to measure patient satisfaction and oral health-related quality of life and to assess an association between patients' satisfaction and oral health-related quality of life after implant surgery by using structural equation modeling. MATERIALS AND METHODS: A total of 257 participants who visited 6 dental clinics located in Daegu city for the purpose of implant treatment participated in this study. Six months after completion of implant surgery, the patients' satisfaction and oral health-related quality of life were surveyed. The effect of factors associated with patients' satisfaction such as functions and aesthetics, maintenance and cost on oral health-related quality of life after implant surgery was analyzed using AMOS 4.0. RESULTS: Oral health-related quality of life was improved in all dimensions of OHIP-14 after implant surgery. Functions and aesthetics as well as maintenance had a significant effect on oral health-related quality of life (P<.05), while cost was not a critical factor influencing oral health-related quality of life. CONCLUSION: High satisfaction with functional aspects and maintenance aspects significantly affected good quality of life. The result of this study supported the fact that education and management for patients after implant therapy were positively related to good quality of life based on a theoretical model.
Dental Clinics ; Esthetics ; Humans ; Models, Theoretical ; Patient Satisfaction ; Quality of Life