Background: This study compared hearing outcomes with use of personal sound amplification products (PSAPs) and hearing aids (HAs) in patients with moderate to moderately severe unilateral hearing loss. Methods: Thirty-nine participants were prospectively enrolled, and randomly assigned to use either one HA (basic or premium type) or one PSAP (basic or high-end type) for the first 8 weeks and then the other device for the following 8 weeks. Participants underwent a battery of examinations at three visits, including sound-field audiometry, word recognition score (WRS), speech perception in quiet and in noise, real-ear measurement, and self-report questionnaires. Results: Functional gain was significantly higher with HAs across all frequencies (P < 0.001). While both PSAPs and HAs improved WRS from the unaided condition, HAs were superior to PSAPs. The speech recognition threshold in quiet conditions and signal-to-noise ratio in noisy conditions were significantly lower in the HA-aided condition than in the PSAP-aided condition, and in the PSAP-aided condition than in the unaided condition. Subjective satisfaction also favored HAs than PSAPs in questionnaires, Abbreviated Profile of Hearing Aid Benefit, International Outcome Inventory for Hearing Aids, and Host Institutional Questionnaire. Conclusion While PSAPs provide some benefit for moderate to moderately severe unilateral hearing loss, HAs are more effective. This underscores the potential role of PSAPs as an accessible, affordable first-line intervention in hearing rehabilitation, particularly for individuals facing challenges in accessing conventional HAs.

Purpose: Women are more vulnerable to post-traumatic stress (PTS) than men, causing several health problems. Nurses should understand and work with women who have experienced trauma and provide interventions to promote their physical, social, and mental health. Methods: This quasi-experimental pilot study used a one-group pre-test/post-test design. Data were collected from 14 women recruited between December 2019 and May 2020 from a self-sufficiency support center in South Korea for sexually-exploited women who had experienced trauma. The program consisted of six one-on-one intervention sessions per week for six weeks. Each session averaged 60~120 minutes. Participants were assessed at pre-test, post-test, and one-month follow-up. Changes in outcome variables over time were analyzed using the Wilcoxon signed-rank and Friedman tests. Results: The caring program for health promotion was divided into six sessions: understanding the self, sharing traumatic events and negative emotions, reframing the meaning of traumatic events, identifying thoughts and physical and emotional responses, developing health promotion activities, and maintaining a positive attitude during the process of change. As a result of the caring program, PTS (F = 36.33, p < .001), depression (F = 24.45, p < .001), health-promoting behaviors (F = 7.06, p = .004), and self-esteem (F = 19.74, p < .001) among the participants differed significantly at pre-test, post-test, and follow-up. Conclusion This study provides foundational information for the implementation of a theory-driven program by nurses in clinical and community settings to provide comprehensive care for women who have experienced trauma.

Background and Objectives: The quality of life after thyroidectomy, such as voice change, is considered to be as important as control of the disease. In this study, we aimed to evaluate changes in both subjective and objective voice parameters after thyroidectomy resulting in normal morbidity of the vocal cords.Materials and Method In this prospective cohort study, 204 patients who underwent thyroidectomy with or without central neck dissection at a single referral center from Feb 2015 to Aug 2016 were enrolled. All patients underwent prospective voice evaluations including both subjective and objective assessments preoperatively and then at 2 weeks, 3, 6, and 12 months postoperatively. Temporal changes of the voice parameters were analyzed. Results: Values of the subjective assessment tool worsened during the early postoperative follow-up period and did not recover to the preoperative values at 12 months postoperatively. The maximal phonation time gradually decreased, whereas most objective parameters, including maximal vocal pitch (MVP), reached preoperative values at 3–6 months postoperatively. The initial decrease in MVP was significantly greater in patients undergoing total thyroidectomy, and their MVP recovery time was faster than that of patients undergoing lobectomy (p=0.001). Patients whose external branch of the superior laryngeal nerve was confirmed intact by electroidentification showed no difference in recovery speed compared with patients without electroindentification (p=0.102), although the initial decrease in MVP was lower with electroidentification. Conclusion Subjective assessment in voice quality and maximal phonation time after thyroidectomy did not show recovery to preoperative values. Aggravation of MVP was associated with surgical extent and electroidentification.

Purpose: Deregulation of SNCA encoding α-synuclein (α-SYN) has been associated with both the familial and sporadic forms of Parkinson disease (PD). Epigenetic regulation plays a crucial role in PD. The intron1 of SNCA harbors a large unmethylated CpG island. Ten-eleven translocation methylcytosine dioxygenase 1 (TET1), a CpG island binding protein, can repress gene expression by occupying hypomethylated CpG-rich promoters, and therefore SNCA could be a target for TET1. We investigated whether TET1 binds to SNCA-intron1 and regulates gene expression. Methods: The dopaminergic neuronal cell line, ReNcell VM, was used. Reverse transcription-polymerase chain reaction (RT-PCR), real time-quantitative PCR, Western blot, dot-blot, and Chromatin immunoprecipitation were conducted. The substantia nigra tissues of postmortem PD samples were used to confirm the level of TET1 expression. Results: In the human dopaminergic cell line, ReNcell VM, overexpression of the DNA-binding domain of TET1 (TET1-CXXC) led to significant repression of α-SYN. On the contrary, knocking down of TET1 led to significantly higher expression of α-SYN. However, overexpression of the DNA-hydroxymethylating catalytic domain of TET1 failed to change the expression of α-SYN. Altogether, we showed that TET1 is a repressor for SNCA, and a CXXC domain of TET1 is the primary mediator for this repressive action independent of its hydroxymethylation activity. TET1 levels in PD patients are significantly lower than that in the controls. Conclusions We identified that TET1 acts as a repressor for SNCA by binding the intron1 regions of the gene. As a high level of α-SYN is strongly implicated in the pathogenesis of PD, discovering a repressor for the gene encoding α-SYN is highly important for developing novel therapeutic strategies for the disease.

Endoscopic ultrasound (EUS)-guided gallbladder (GB) drainage has recently emerged as a more feasible treatment than percutaneous transhepatic GB drainage for acute cholecystitis. In EUS-guided cholecystostomies in patients with distended GBs without pericholecystic inflammation or prominent wall thickening, a needle puncture with tract dilatation is often difficult. Guidewires may slip during the insertion of thin and flexible drainage catheters, which can also cause the body portion of the catheter to be unexpectedly situated and prolonged between the GB and intestines because the non-inflamed distended GB is fluctuant. Upon fluoroscopic examination during the procedure, the position of the abnormally coiled catheter may appear to be correct in patients with a distended stomach. We experienced such an adverse event with fatal bile peritonitis in a patient with GB distension suggestive of malignant bile duct stricture. Fatal bile peritonitis then occurred. Therefore, the endoscopist should confirm the indications for cholecystostomy and determine whether a distended GB is a secondary change or acute cholecystitis.

Background and Objectives: This case series is aimed to introduce a new term, antrovestibular polyp (AVP), for an antral polyp herniating anteriorly toward the nasal vestibule and to describe an antral polyp direction of growth through the anterior and posterior fontanelles.Materials and Method: This is a retrospective study involving review of patients who underwent surgery due to maxillary sinus polyp herniating anteriorly toward the nasal vestibular area or posteriorly toward the choana at a tertiary training hospital from January 2007 through July 2016. Their demographic data, computed tomography scan findings, and endoscopic evaluations were analyzed. Results This study included 49 subjects; 8 (16.33%, 6 males) with AVP and 41 (83.67%, 24 males) with antrochoanal polyps (ACP). The mean ages of AVP and ACP patients were 9 and 14.4 years, respectively (p=0.006). The subjects were identified as AVP when computed tomography scan showed an antral polyp directed anteriorly toward the nasal vestibular area, while polyps growing toward the choana were identified as ACP. Endoscopic review showed that AVP grew out through an accessory ostium located anterior to the uncinate process at the area of the anterior fontanelle, while ACP started from an accessory ostium of the posterior fontanelle or a widened maxillary natural ostium.