Background and Objectives: To describe and evaluate modified circumferential subannular tympanoplasty (MCST) via endoscopic approach, we compared the results of MCST to those of the underlay technique and the results of previous studies.Subjects and Method A retrospective comparative study was conducted of 31 patients who underwent endoscopic transcanal tympanoplasty. Patients were classified into the MCST group (n=11) and the underlay group (n=20) according to the graft technique. Demographic data, size and location of the perforation, pre- and postoperative hearing, operating time, complication rate, and graft success rate were analyzed in each group. Results: No significant differences between the two groups were observed in the demographic data or the locations of the perforations. The sizes of the perforations were 31.4±14.3% and 25.0±18.1%, respectively. The average operating times were 68.6±16.5 min and 64.9±9.3 min, respectively, and canaloplasty was not required in any patient. The postoperative hearing improvement and air-bone gap were not significantly different. No postoperative complications were observed in either group. Conclusion MCST is a feasible and effective technique for endoscopic transcanal tympanoplasty. The postoperative results and operating times of MCST were comparable to those of other graft techniques. MCST showed more stable results in anterior perforation than in underlay graft.

Bilateral sudden sensorineural hearing loss (SSNHL) is rare and usually indicates a serious systemic pathology. We describe an unusual case of bilateral SSNHL caused by sepsis. A 28-year-old female complained of acute-onset bilateral hearing impairment; in addition to otological symptoms, she had a systemic condition that met the criteria for sepsis. We performed a physical examination and laboratory tests to diagnose sepsis. Pure tone audiogram and videonystagmography were performed to evaluate the otological symptoms. Intravenous antibiotics and high-dose methylprednisolone were prescribed for treatment, and audiogram was repeated during that period. The fever subsided and the vital signs were stabilized. The electrolyte imbalance and abnormal urine parameters became normal. Hearing gradually recovered to a normal level on day 7 of hospitalization. In conclusion, sepsis should be considered as a cause of SSNHL. When conducting a detailed examination of patients with bilateral SSNHL, the clinician should consider systemic disease.

Arnold-Chiari malformation type 1 is a congenital disease characterized by herniation of the cerebellar tonsils through the foramen magnum. Most common clinical symptom is pain, including occipital headache and neck pain, upper limb pain exacerbated by physical activity or valsalva maneuvers. Various otoneurological manifestations also occur in patients with the disease, which has usually associated with dizziness, vomiting, dysphagia, poor hand coordination, unsteady gait, numbness. Patients with Arnold-Chiari malformation may develop vertigo after spending some time with their head inclined on their trunk. Positional and down-beating nystagmus are common forms of nystagmus in them. We experienced a 12-year-old female who presented complaining of vertigo related to changes in head position which was initially misdiagnosed as a benign paroxysmal positional vertigo.
Arnold-Chiari Malformation ; Benign Paroxysmal Positional Vertigo ; Child ; Deglutition Disorders ; Dizziness ; Female ; Foramen Magnum ; Gait Disorders, Neurologic ; Hand ; Head ; Headache ; Humans ; Hypesthesia ; Motor Activity ; Neck Pain ; Palatine Tonsil ; Upper Extremity ; Valsalva Maneuver ; Vertigo ; Vomiting

OBJECTIVE: Since the 2000s, CyberKnife radiosurgery (CKRS) is either a primary or an adjunct management approach used to treat patients with vestibular schwannoma (VS). The goals of CKRS are prevention of tumor growth, preservation of cranial nerve function and prevention of new neurologic deficiencies. The aim of this study was to assess the efficacy and safety of CKRS, in terms of tumor control, hearing preservation, and complications. METHODS: Forty patients with VS underwent CKRS as a treatment modality for from January 2010 to February 2016. The long term results of 32 patients were evaluated who received CKRS as primary treatment. 8 patients presented with previously performed surgical resection. Information related to clinical history, Brain MRI and outcomes of patients with VS collected retrospectively by reviewing patient's chart and telephone survey. RESULTS: The mean tumor volume was 3.3 cm³ and the mean follow-up was 41 months. The most recent follow-up showed that tumor size decreased in 17 patients (42.5%), displayed no change in 19 patients (47.5%), and increased in 4 patients (10%). Progression-free survival rates after CKRS at 1, 3, and 5 years were 95%, 90%, and 90%. After CKRS, 13 patients experienced hearing degradation. The overall rate of preservation of serviceable hearing at the long-term follow-up was 60%. Vertigo, ataxia, and headache were improved after CKRS compared with pretreated status. But, facial weakness, trigeminal nerve neuropathy, and tinnitus were worsen. CONCLUSION: CKRS provide an excellent tumor control rate and a comparable hearing preservation rate in VS patients. Also CKRS is associated with low rate of cranial neuropathy, other complications.
Ataxia ; Brain ; Cranial Nerve Diseases ; Cranial Nerves ; Disease-Free Survival ; Follow-Up Studies ; Headache ; Hearing ; Humans ; Magnetic Resonance Imaging ; Neuroma, Acoustic ; Radiosurgery ; Retrospective Studies ; Telephone ; Tinnitus ; Trigeminal Nerve ; Tumor Burden ; Vertigo

PURPOSE: Helicopter parenting is emerging in parenting as a way of rearing adolescents and adult children. The aims of this study were to develop a Korean version of the Helicopter Parenting and Autonomy Supportive Behaviors Scale (HPASB). METHODS: The HPASB questionnaire items were translated into Korean and reviewed by experts and Content Validity Index (CVI) in a preliminary study with 10 university students. During September and October, 2014 data were collected from 229 nursing students from five different universities in different locations. For data analysis, SPSS 21.0 statistics which included exploratory factor analysis, t-test, one-way ANOVA were utilized. RESULTS: Content validity was over CVI .8. The 6 factors of K-HPASB were extracted and accounted for 59.30% of variance. The Cronbach's alpha coefficient was .71 indicating high reliability. CONCLUSION: The Korean version of the HPASB was identified as a scale with a high degree of validity and reliability. The results of this study provide a valuable scale which can be useful in the study of parenting as a way of rearing adolescents and adult children in Korea. To enhance the positive aspect of helicopter parenting, we suggest the development of intervention programs on parenting.
Adolescent ; Adult Children ; Aircraft* ; Humans ; Korea ; Parenting* ; Parents* ; Reproducibility of Results* ; Statistics as Topic ; Students, Nursing

PURPOSE: Helicopter parenting is an emerging concept as a way of rearing adolescents and adult children. However, helicopter parenting from a nursing perspective has not been elucidated. Therefore, we undertook a concept analysis to understand the attributes, antecedents and consequences of helicopter parenting in the context of nursing. METHODS: Using Rodgers' evolutionary concept analysis, we analyzed literature on helicopter parenting to discover critical attributes, antecedents, and consequences of this phenomenon. Data were collected from seven electronic search engines. Twelve studies matching inclusion criteria were reviewed RESULTS: Three core attributes of helicopter parenting were hovering, highly deep involvement, and proxy decision making. The antecedents and consequences were retrieved from three important domains including social, parent, and child aspects. Surrogate terms were black hawk, hummingbird, and hovercraft parenting, and related terms were stealth fighter and Kamikaze parenting. CONCLUSION: Based on the results of this study, helicopter parenting has both positive and negative effects on both children and parents. To enhance the positive effects, measurement tools for helicopter parenting and nursing interventions on parenting need to be developed.
Adolescent ; Adult Children ; Aircraft* ; Child ; Concept Formation ; Decision Making ; Family Relations ; Hawks ; Humans ; Nursing ; Parenting* ; Parents* ; Proxy ; Search Engine

As well-being foods pursuing healthy life are becoming popular, interest in Rubus coreanus Miquel (RCM) fruit, a type of Korean blackberry, is increasing due to its medicinal actions including protecting the liver, brightening the eyes, and alleviating diabetes. This study was carried out to evaluate the hepatoprotective effects of RCM concentrates on liver injuries induced by carbon tetrachloride (CCl4) in rats. RCM, produced in June ~ July 2008 at Chunbook, Gochang (South Korea), was finely mashed. The seeds were removed and the juices were condensed. Thirty-two Sprague-Dawley rats were divided into four groups according to treatment: normal (eight rats), CCl4, 1% RCM, and 2% RCM. Experimental diets were provided to the experimental animals for 4 weeks. We measure total cholesterol, high density lipoprotein-cholesterol (HDL-C), aspartate amino transferase (AST), alanine amino transferase (ALT), and alkaline phosphatase (ALP) levels. Part of the livers was isolated for histopathological evaluation, and analyzed for lipid peroxide (TBARS), superoxide dismutase (SOD) and liver proteins. The activities of serum AST, ALT, and ALP were elevated following CCl4 administration. Levels of hepatic TBARS were also significantly increased in the CCl4 groups. However, hepatic TBARS levels and the activities of serum enzymes were markedly reduced by supplementation with the RCM concentrates (P < 0.05). Hepatic SOD activity increased in the RCM concentrates group versus CCl4 groups. Histopathological examination revealed massive necrosis in the centrilobular area and degenerative changes caused by CCl4 were ameliorated by dietary supplementation with RCM concentrates. These results suggest that RCM concentrates have hepatoprotective effects and may improve the symptoms of liver injuries.
Alanine ; Alkaline Phosphatase ; Animals ; Aspartic Acid ; Carbon Tetrachloride* ; Carbon* ; Cholesterol ; Diet ; Dietary Supplements ; Fruit ; Liver* ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Thiobarbituric Acid Reactive Substances ; Transferases

BACKGROUND: The usefulness of cerebrospinal fluid (CSF) concentrations of amyloid beta protein 1-42 (Abeta42), phosphorylated tau (pTau) and total tau (tTau) have been increasing in Alzheimer's disease (AD). However, the direct adoption of previously reported standard values is not appropriate due to interlaboratory variability. We started this study to set up an accessible system to measure CSF biomarkers in our country with high reproducibility and validity. METHODS: Including CSFs from four different institutes the levels of Abeta42, pTau181 and tTau were measured in one lab. The intertest variability and difference in the levels of biomarkers depending on diseases were assessed. Through analysis of receiver operating characteristic cut points and binary logistic regression the cut-off values of Abeta42, pTau and tTau level were obtained, and their validity was evaluated. RESULTS: The intertest consistency was high in measuring CSF biomarkers. The value of Abeta42 was markedly decreased in AD (n= 17) and other dementia (n= 9) compared to normal control (n= 12). The levels of pTau181 and tTau were high in AD, but not in other dementia and normal control. The threshold values of Abeta42, pTau181 and tTau were 290.3 pg/mL, 54.3 pg/mL, and 320.7 pg/mL in differentiating AD from normal control showing high sensitivity and specificity. Especially, the ratios of pTau181/Abeta42 (> 0.16) and tTau/Abeta42 (> 0.76) showed the prime validity. CONCLUSIONS: Our data of CSF Abeta42, pTau181, and tTau levels were highly reproducible. PTau181/Abeta42 and tTau/Abeta42 ratios were the greatly helpful in differentiating AD from normal control.
Academies and Institutes ; Adoption ; Alzheimer Disease ; Amyloid beta-Peptides ; Biomarkers ; Dementia ; Enzyme-Linked Immunosorbent Assay ; Logistic Models ; Pyridines ; ROC Curve ; Sensitivity and Specificity ; Thiazoles

The National Evidence-based Collaborating Agency (NECA) holds the NECA Round-table Conference that not only disseminates objective and systematic information on topics of social concern in public health care but also organizes discussions on core issues under dispute in the literature through panels composed of multidisciplinary experts. Accordingly, the Round-table Conference was composed of multidisciplinary experts including medical specialists in the areas of psychiatry and preventive medicine, psychiatric and mental health nursing, psychologists, social welfare experts, consultation experts, religious leaders, and government officials from the Ministry of Education, Science and Technology, and Ministry of Health and Welfare. The Round-table Conference, tasked with analysis of the actual status and causes of, and search for solutions for suicide in adolescents, has reached consensus on the current status, trend, risk factors and prevention factors, problems and issues in prevention and coping strategies, effective prevention and coping strategies and areas of research needed for the future. The Round-table Conference commented on the actual status and gravity of suicides in adolescents, and came to the agreement that mental health issues including stress from interpersonal relationships and depression are the key risk factors of suicide. It was further agreed that problems in the measures being implemented for each of the areas include lack of manpower and funding, and inadequate organic association and cooperation among relevant institutions. They also agreed that development of a government-initiated suicide prevention program for adolescents, association among relevant experts, and development, and management of practical guidelines that are of broad and practical use are important. Furthermore, the panels were in agreement that the mass media must comply with the recommended level of coverage in reporting of suicide as adolescents are greatly influenced by provocative mass media reports due to their strong impulsive dispositions.
Adenosine-5'-(N-ethylcarboxamide) ; Adolescent ; Cause of Death ; Consensus ; Depression ; Dissent and Disputes ; Financial Management ; Gravitation ; Humans ; Mass Media ; Mental Health ; Occupational Groups ; Porphyrins ; Preventive Medicine ; Public Health ; Risk Factors ; Social Welfare ; Specialization ; Suicide

BACKGROUND/AIMS: The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Barrett Esophagus ; Biopsy ; Chest Pain ; Cough ; Esophagus ; Gastroesophageal Reflux ; Heartburn ; Hoarseness ; Light ; Metaplasia ; Microscopy ; Prospective Studies ; Proton Pumps ; Sensation