Purpose: We aimed to assess the characteristics of patients with concurrent tinnitus and hyperacusis, determine the best audiological criteria for predicting hyperacusis, and confirm whether objective evidence of changes in the brain exists. Materials and Methods: The medical records of patients with tinnitus who visited the hospital between March 2020 and December 2021 were reviewed. Data on accompanying hyperacusis, audiological profiles, and questionnaires including the Tinnitus Handicap Inventory (THI), Beck Depression Inventory, and numerical rating scale were analyzed. Resting-state quantitative electroencephalography (qEEG) using power spectral density (PSD) and event-related spectral perturbation (ERSP) were performed to objectively quantify changes in the brain. Results: A total of 194 patients were analyzed. Among them, 51 (26.3%) reported combined subjective hyperacusis with tinnitus.However, the proportions widely varied from 7.4% to 68.4% based on three audiological criteria for assessment. A higher score on the THI questionnaire was independently associated with the co-occurrence of tinnitus and hyperacusis. Fair agreement was observed between subjective hyperacusis and the audiological criterion based on a loudness discomfort level (LDL) of ≤90 dB at two or more frequencies for the diagnosis of hyperacusis. An increased beta-PSD and decreased levels of gamma-PSD, all-ERSP, and delta-ERSP were observed in patients with hyperacusis (p<0.05). Conclusion Patients with co-occurring tinnitus and hyperacusis had more severe tinnitus distress. An LDL of ≤90 dB at two or more frequencies may be applicable to predict accompanying hyperacusis in subjects with tinnitus, and qEEG also provides more objective information.

Purpose: We aimed to assess the characteristics of patients with concurrent tinnitus and hyperacusis, determine the best audiological criteria for predicting hyperacusis, and confirm whether objective evidence of changes in the brain exists. Materials and Methods: The medical records of patients with tinnitus who visited the hospital between March 2020 and December 2021 were reviewed. Data on accompanying hyperacusis, audiological profiles, and questionnaires including the Tinnitus Handicap Inventory (THI), Beck Depression Inventory, and numerical rating scale were analyzed. Resting-state quantitative electroencephalography (qEEG) using power spectral density (PSD) and event-related spectral perturbation (ERSP) were performed to objectively quantify changes in the brain. Results: A total of 194 patients were analyzed. Among them, 51 (26.3%) reported combined subjective hyperacusis with tinnitus. However, the proportions widely varied from 7.4% to 68.4% based on three audiological criteria for assessment. A higher score on the THI questionnaire was independently associated with the co-occurrence of tinnitus and hyperacusis. Fair agreement was observed between subjective hyperacusis and the audiological criterion based on a loudness discomfort level (LDL) of ≤90 dB at two or more frequencies for the diagnosis of hyperacusis. An increased beta-PSD and decreased levels of gamma-PSD, all-ERSP, and delta-ERSP were observed in patients with hyperacusis (p<0.05). Conclusion Patients with co-occurring tinnitus and hyperacusis had more severe tinnitus distress. An LDL of ≤90 dB at two or more frequencies may be applicable to predict accompanying hyperacusis in subjects with tinnitus, and qEEG also provides more objective information.

PURPOSE: Strabismus affects any age and represents various functional or non-functional eye problems. This population-based study was conducted to determine the prevalence of strabismus and nystagmus in South Korea according to various sociodemographic factors. METHODS: We acquired data from the Korea National Health and Nutrition Examination Survey, a nation-wide cross-sectional survey and examinations of the non-institutionalized civilian population in South Korea (n = 30,538), conducted from July 2008 to December 2011. The prevalence of strabismus and nystagmus were verified, and associated sociodemographic factors was evaluated. RESULTS: The overall prevalence of strabismic disorder in participants over 3 years of age was 1.4 ± 0.1% (95% confidence interval [CI] 1.3–1.6%; 1.5 ± 0.1% in males, 1.3 ± 0.1% in females). The prevalence of exodeviation (15 or more prism diopters), esodeviation (10 or more prism diopters), vertical deviation, and other complicated strabismus and nystagmus was 1.0%, 0.2%, 0.2%, 0.1% and 0.1% respectively. The prevalence was highest in the 6 to 15-year age group (1.9 ± 0.3%), and lowest in the 40 to 49 years age group (0.8 ± 0.1%) (p = 0.005). There were no statistically significant differences for gender, region, residential area, household income, educational level and occupation. CONCLUSIONS: This nation-wide epidemiologic study demonstrated that the prevalence of strabismus and nystagmus according to various sociodemographic factors in South Korea was not statistically significant except for age group. Further investigations are required based on more surveys to better recognize the etiologic or risk factors that may be related to strabismus and nystagmus.
Cross-Sectional Studies ; Epidemiologic Studies ; Esotropia ; Exotropia ; Family Characteristics ; Humans ; Korea* ; Male ; Nutrition Surveys ; Occupations ; Prevalence ; Risk Factors ; Strabismus*

Stent migration and loss are rare but can be devastating complications during percutaneous coronary intervention (PCI) for coronary artery disease. We report a unique case of wandering stent from the right coronary artery to the femoral artery via the axillary artery. Initially, the stent was stripped from the delivery catheter and embolized to axillary artery during emergent PCI. An intra-aortic balloon pump might have forced retrograde movement of the stent to axillary artery which have subsequently remobilized to the femoral artery. After stabilization, the stent was successfully removed by a percutaneous approach using a snare. Immediate retrieval of wandering stent is recommended for the prevention of secondary embolization.
Axillary Artery* ; Catheters ; Coronary Artery Disease ; Coronary Vessels ; Drug-Eluting Stents ; Embolism ; Femoral Artery* ; Percutaneous Coronary Intervention ; SNARE Proteins ; Stents*

Androgen receptor (AR) signaling is important for prostate cancer (PCa) cell proliferation. Here, we showed that proliferation of hormone-sensitive prostate cancer cells such as LNCaP was significantly enhanced by testosterone stimulation whereas hormone-insensitive prostate cancer cells such as PC3 and VCaP did not respond to testosterone stimulation. Blocking of AR using bicalutamide abolished testosterone-induced proliferation of LNCaP cells. In addition, knockdown of AR blocked testosterone-induced proliferation of LNCaP cells. Basal expression of low-density lipoprotein receptor-related protein 6 (LRP6) was elevated in VCaP cells whereas stimulation of testosterone did not affect the expression of LRP6. However, expression of LRP6 in LNCaP cells was increased by testosterone stimulation. In addition, knockdown of LRP6 abrogated testosterone-induced proliferation of LNCaP cells. Given these results, we suggest that androgen-dependent expression of LRP6 plays a crucial role in hormone-sensitive prostate cancer cell proliferation.
Cell Proliferation* ; Low Density Lipoprotein Receptor-Related Protein-6* ; Prostatic Neoplasms* ; Receptors, Androgen ; Testosterone

Metabolic acidosis was shown to correlate with deterioration of renal function in patients with rhabdomyolysis. The present study was aimed to investigate whether the changes of type 3 Na+/H+ exchanger (NHE3), type 1 Na+/HCO3- cotransporter (NBC1), and Na+,K+-ATPase alpha1 subunit may play a role in the pathogenesis of metabolic acidosis in glycerol-induced experimental rhabdomyolysis. Male Sprague-Dawley rats were deprived of fluid intake for 24 hours, and then were injected with 50% glycerol in normal saline (10 mL/kg, intramuscularly). At 24 hours after the glycerol injection, rats were sacrificed by decapitation. Control rats were injected with normal saline. The protein expression of NHE3, NBC1 and Na+,K+-ATPase alpha1 subunit was determined in the cortex of the kidney by immunoblotting and immunohistochemistry. Following the treatment of glycerol, creatinine clearance was significantly decreased, and high anion gap metabolic acidosis developed. In the experimental group, the expression of Na+,K+-ATPase alpha1 subunit was significantly decreased in the cortex of the kidney. On the contrary, the expression of NHE3 and NBC1 was significantly increased. Immunohistochemical analyses confirmed the immunoblotting data. In conclusion, the coordinate up-regulation of NHE3 and NBC1 may play an adaptive role against the metabolic acidosis in glycerol-induced rhabdomyolysis.
Acid-Base Equilibrium ; Acidosis ; Animals ; Creatinine ; Decapitation ; Glycerol ; Humans ; Immunoblotting ; Immunohistochemistry ; Kidney* ; Male ; Rats* ; Rats, Sprague-Dawley ; Rhabdomyolysis* ; Up-Regulation

Complex regional pain syndrome (CRPS) is quite difficult to comprehend and manage, of which etiology and pathophysiological mechanisms have not been fully understood. CRPS is classified as either type 1 (without any known nerve injury) or type 2 (with apparent nerve or tissue injury). Spinal cord stimulation is a restorative therapy that currently offers the best chances of obtaining long-term pain relief in CRPS patients with pain that has not responded to other treatments such as physical therapy or analgesic medications. A 45 years old male patient referred to our pain clinic due to uncontrolled pain at the middle finger for 4 years after crushing injury. He was diagnosed with CRPS type 2 and treated with medication, stellate ganglion block, thoracic sympathetic block, and pulsed radiofrequency therapy, but their effects were transient and not satisfactory. A percutaneous spinal cord stimulation (SCS) with a single quadripolar electrode was tried and the patient's finger pain was improved significantly (from VAS 10 to 2). SCS is an effective treatment for CRPS type 2 which results from crushing injury when alternative therapies fail.
Complementary Therapies ; Electrodes ; Fingers* ; Humans ; Male ; Middle Aged ; Pain Clinics ; Spinal Cord Stimulation* ; Spinal Cord* ; Stellate Ganglion

We report a case in which epidural anesthesia was successfully administered during a cesarean section of a 35 years old parturient patient with severe congestive heart failure and respiratory insufficiency at 33 weeks of gestation. The patient had a past history of mitral regurgitation and mitral valve prolapse treated by mitral valve replacement ten years prior. When limited motion of the prosthetic mitral valve developed, congestive heart failure recurred and was aggravated by the pregnancy. In addition, the patient presented with symptoms of respiratory insufficiency including NYHA III dyspnea, orthopnea, severe pulmonary hypertension (systolic pulmonary arterial pressure: 112 mmHg) due to severe aortic regurgitation, pleural effusion and pulmonary edema on admission. Four-days after admission, with premature labor pain and fetal distress, the patient underwent an emergency cesarean section. Due to the orthopnea, the patient could not breathe in the supine position, and we chose to give epidural anesthesia at a sitting position for preserving self-respiration and to prevent a ventilation-perfusion mismatch that would possibly develop during general anesthesia. Moreover, we could control postoperative pain and maintain a minimal, gradual hemodynamic change throughout the epidural anesthesia. During surgery, the hemodynamic instabilities were controlled by the use of dopamine, dobutamine, ephedrine and milrinone. We safely finished the cesarean section under epidural anesthesia and the patient was sent to the intensive care unit postoperatively to manage congestive heart failure and respiratory insufficiency.
Adult ; Anesthesia, Epidural* ; Anesthesia, General ; Aortic Valve Insufficiency ; Arterial Pressure ; Cesarean Section* ; Dobutamine ; Dopamine ; Dyspnea ; Emergencies ; Ephedrine ; Estrogens, Conjugated (USP)* ; Female ; Fetal Distress ; Heart Failure* ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Intensive Care Units ; Milrinone ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Obstetric Labor, Premature ; Pain, Postoperative ; Pleural Effusion ; Pregnancy ; Pulmonary Edema ; Respiratory Insufficiency* ; Supine Position

BACKGROUND: The aim of this prospective, double-blind randomized study was to compare the clinical properties of sevoflurane-alfentanil with propofol-remifentanil anesthesia in patients undergoing a laparoscopic cholecystectomy. METHODS: Forty patients (ASA physical status 1, 2) scheduled for elective surgery received total intravenous anesthesia (TIVA group) with remifentanil and propofol or sevoflurane-alfentanil. The TIVA group was induced with propofol 5 microgram/ml and remifentanil 4.5 ng/ml. The anesthesia was maintained with a continuous infusions of propofol 2.5 microgram/ml and remifentanil 3 ng/ml. The sevoflurane-alfentanil group was induced with alfentanil 15 microgram/kg and propofol 1.5 mg/kg IV. Maintenance was obtained with 2.0 vol% sevoflurane and a bolus of alfentanil 10microgram/kg IV where needed. RESULTS: There were no significant differences in the systolic and diastolic blood pressure and heart rate between the two groups. There were no significant differences in the time to eye opening, the time to extubation, post-anesthetic recovery room stay time and the incidence of postoperative nausea and vomiting between the two groups. CONCLUSIONS: Propofol-remifentanil (TIVA) and sevoflurane-alfentanil both provided satisfactory anesthesia for a laparoscopic cholecystectomy.
Alfentanil ; Anesthesia* ; Anesthesia, Intravenous* ; Blood Pressure ; Cholecystectomy, Laparoscopic* ; Heart Rate ; Humans ; Incidence ; Postoperative Nausea and Vomiting ; Propofol ; Prospective Studies ; Recovery Room

We had done one-lung ventilation using 9 Fr wire-guided endobronchial blocker and outer diameter 41-mm flexible fiberoptic bronchoscope in ruptured esophageal patient who expected difficult tracheal intubation and in esophageal cancer patient who was in need of mechanical ventilation during and after the operation.
Bronchoscopes ; Esophageal Neoplasms ; Humans ; Intubation ; One-Lung Ventilation* ; Respiration, Artificial