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Purpose@#Tinnitus is one of the most common health conditions worldwide. Although various methods of treatment have been used, the condition is still difficult to manage or cure. This study aimed to evaluate the therapeutic effects of transcutaneous trigeminal electrical stimulation (TTES) combined with notched sound therapy (NST) on patients with tinnitus. @*Materials and Methods@#A clinical trial was conducted prospectively from September 2020 to September 2021 at a single center in South Korea. In total, 14 patients took part in this trial. Periodic visits and tele-monitoring were used to assess treatment compliance and collect data, including electroencephalography (EEG), photoplethysmography (PPG), tinnitus handicap inventory (THI), tinnitus magnitude index, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and 36-item short-form survey (SF-36) results. @*Results@#Changes after intervention were analyzed with paired t-test. This study showed that alpha waves in the left hemisphere measured by EEG (p=0.024), autonomic nervous system balance (p=0.007), and stress level (p=0.022) measured by PPG significantly changed after intervention. Also, THI scores especially emotional symptoms (p=0.029) and catastrophic symptoms (p=0.043) decreased after treatment. The SF-36 score, both mental component summary and physical component summary score (each p<0.001), increased significantly, whereas the PSQI score (p<0.001) and BDI score (p<0.001) decreased after TTES and NST. @*Conclusion@#Based on the results of our study, we could confirm that TTES combined with NST can significantly improve tinnitus, catastrophic symptoms, and the overall quality of life of patients.
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Emerging evidence suggests that controlling both glycemic variability and hemoglobin A1c is necessary to prevent complications associated with diabetes mellitus. Hence, continuous glucose monitoring (CGM) is crucial for effectively managing diabetes.Current Concepts: There are two primary types of CGM. Retrospective CGM only allows the reviewal of glycemic data after the monitoring period, whereas personal CGM allows real-time monitoring. Personal CGM can be further categorized into real-time CGM and intermittently scanned CGM. To interpret CGM data, time in range (TIR) is considered the standard parameter. A TIR of 70–180 mg/dL for more than 70% of the period has been established as a typical target for both type 1 and type 2 diabetes. Other parameters such as time below range, time above range, coefficient of variation, and glucose management indicator should also be reviewed. Importantly, numerous clinical studies have demonstrated the efficacy of CGM in both type 1 and type 2 diabetes.Discussion and Conclusion: A wealth of clinical evidence supports the application of CGM in diabetes, confirming its effectiveness across various treatment stages. CGM has emerged as a compelling therapeutic option in instances when other treatment choices remain limited. With a growing body of clinical evidence, the widespread adoption of CGM in diabetes management appears inevitable. However, challenges related to user comfort, cost, the need for extensive data interpretation, and necessary system improvements remain unaddressed. Further research is required to validate the appropriate usage and frequency of CGM through costeffectiveness analyses.
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Background@#The aim of this study was to capture multifaceted clinical characteristics of congenital cytomegalovirus (CMV) infection from diagnosis to treatment using a multidisciplinary approach including obstetrics, pediatrics, pathology, and otorhinolaryngology-head and neck surgery. @*Methods@#This is a retrospective study including 30 consecutive cases of congenital CMV infection that were diagnosed at a single tertiary hospital located in Seoul, Korea from January 2009 to December 2020. Congenital CMV infection was defined as a positive result by polymerase chain reaction from urine, saliva or cerebrospinal fluid or positive CMV IgM from neonatal blood sampled within 3 weeks after birth. All cases were analyzed with respect to whole clinical characteristics from diagnosis to treatment of congenital CMV by a multidisciplinary approach including prenatal sonographic findings, maternal immune status regarding CMV infection, detailed placental pathology, neonatal clinical manifestation, auditory brainstem response test, and antiviral treatment (ganciclovir or valganciclovir). Long-term outcomes including developmental delay and hearing loss were also investigated. @*Results@#The total number of births during the study period in our institution was 19,385, with the prevalence of congenital infection estimated to be 0.15%. Among 30 cases of congenital CMV, the median gestational age at delivery was 32.2 weeks [range, 22.6–40.0] and 66.7% of these infants were delivered preterm at less than 37 weeks. Suspected fetal growth restriction was the most common prenatal ultrasound finding (50%) followed by ventriculomegaly (17.9%) and abnormal placenta (17.9%), defined as thick placenta with calcification. No abnormal findings on ultrasound examination were observed in one-third of births. Maternal CMV serology tests were conducted in only 8 cases, and one case each of positive and equivocal IgM were found. The most common placental pathologic findings were chronic villitis (66.7%) and calcification (63.0%), whereas viral inclusions were identified in only 22.2%. The most common neonatal manifestations were jaundice (58.6%) followed by elevation of aspartate aminotransferase (55.2%) and thrombocytopenia (51.7%). After excluding cases for which long-term outcomes were unavailable due to death (n = 4) or subsequent follow up loss (n = 3), developmental delay was confirmed in 43.5% of infants (10/23), and hearing loss was confirmed in 42.9% (9/21) during the follow-up period. In our cohort, 56.7% (17/30) of neonates were treated for congenital CMV with ganciclovir or valganciclovir. @*Conclusion@#Our data show that prenatal findings including maternal serologic tests and ultrasound have limited ability to detect congenital CMV in Korea. Given that CMV is associated with high rates of developmental delay and hearing loss in infants, there is an urgent need to develop specific strategies for the definite diagnosis of congenital CMV infection during the perinatal period by a multidisciplinary approach to decrease the risks of neurologic impairment and hearing loss through early antiviral treatment.
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Background@#Coronary artery calcium score (CACS) has become an important tool for evaluating cardiovascular disease (CVD). This study evaluated the significance of CACS for future CVD through more than 10 years of follow-up in asymptomatic Korean populations with type 2 diabetes mellitus (T2DM) known to have a relatively low CACS burden. @*Methods@#We enrolled 981 asymptomatic T2DM patients without CVD at baseline who underwent CACS evaluation using multidetector computed tomography between January 2008 and December 2014. They were grouped into five predefined CACS categories based on Agatston scores and followed up by August 2020. The primary endpoint was incident CVD events, including coronary, cerebrovascular, and peripheral arterial disease. @*Results@#The relative risk of CVD was significantly higher in patients with CACS ≥10, and the significance persisted after adjustment for known confounders. A higher CACS category indicated a higher incidence of future CVD: hazard ratio (95% confidence interval) 4.09 (1.79 to 9.36), 12.00 (5.61 to 25.69), and 38.79 (16.43 to 91.59) for 10≤ CACS <100, 100≤ CACS <400, and CACS ≥400, respectively. During the 12-year follow-up period, the difference in event-free survival more than doubled as the category increased. Patients with CACS below 10 had very low CVD incidence throughout the follow-up. The receiver operating characteristic analysis showed better area under curve when the CACS cutoff was 10 than 100. @*Conclusion@#CACS can be a sensitive marker of CVD risk. Specifically, CACS above 10 is an indicator of CVD high-risk requiring more intensive medical treatment in Koreans with T2DM.
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Objectives@#. Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations. @*Methods@#. This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data. @*Results@#. In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable results. Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, –11.351; 95% confidence interval, –21.491 to –1.212; P=0.028). @*Conclusion@#. This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations.
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Background@#The purpose of this study was two-fold: 1) to identify differences in the characteristics of adopters and non-adopters of hearing aids (HAs); and 2) to investigate factors influencing the purchase of HA. @*Methods@#This study was conducted among 1,464 subjects (818 male and 646 female) with hearing loss. A national face-to-face survey was performed from August 2019 to October 2020 by otologists or HA experts. The questionnaire consisted of three domains:demographic, audiological, and HA-related domains. Multivariate logistic regression analysis was performed after adjusting for degree of hearing loss. @*Results@#The mean age of the participants was 70.4 ± 12.2 years. Of the 1,464 respondents, 1,190 (81.3%) had already purchased HA. We identified educational level, household income, hearing loss period, place of HA purchase, and government HA assistance program status as factors influencing HA adoption. Among these factors, third party reimbursement was the most important factor affecting HA purchase intent. The main reasons for not adopting HA were feeling that their hearing was adequate, inability to afford HA, and perceptions that HA are uncomfortable. @*Conclusion@#Various factors are involved in the purchase of HA, but disabled registration status and third party reimbursement were identified as the most critical factors. In the future, the government should take a more active role in increasing the distribution of HA to patients with hearing loss.
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Background@#To compare the efficacy and safety of two insulin self-titration algorithms, Implementing New Strategies with Insulin Glargine for Hyperglycemia Treatment (INSIGHT) and EDITION, for insulin glargine 300 units/mL (Gla-300) in Korean individuals with uncontrolled type 2 diabetes mellitus (T2DM). @*Methods@#In a 12-week, randomized, open-label trial, individuals with uncontrolled T2DM requiring basal insulin were randomized to either the INSIGHT (adjusted by 1 unit/day) or EDITION (adjusted by 3 units/week) algorithm to achieve a fasting self-monitoring of blood glucose (SMBG) in the range of 4.4 to 5.6 mmol/L. The primary outcome was the proportion of individuals achieving a fasting SMBG ≤5.6 mmol/L without noct urnal hypoglycemia at week 12. @*Results@#Of 129 individuals (age, 64.1±9.5 years; 66 [51.2%] women), 65 and 64 were randomized to the INSIGHT and EDITION algorithms, respectively. The primary outcome of achievement was comparable between the two groups (24.6% vs. 23.4%, P=0.876). Compared with the EDITION group, the INSIGHT group had a greater reduction in 7-point SMBG but a similar decrease in fasting plasma glucose and glycosylated hemoglobin. The increment of total daily insulin dose was significantly higher in the INSIGHT group than in the EDITION group (between-group difference: 5.8±2.7 units/day, P=0.033). However, body weight was significantly increased only in the EDITION group (0.6±2.4 kg, P=0.038). There was no difference in the occurrence of hypoglycemia between the two groups. Patient satisfaction was significantly increased in the INSIGHT group (P=0.014). @*Conclusion@#The self-titration of Gla-300 using the INSIGHT algorithm was effective and safe compared with that using the EDITION algorithm in Korean individuals with uncontrolled T2DM (ClinicalTrials.gov number: NCT03406663).
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Purpose@#This study presents our initial experience with endoscopic combined intrarenal surgery (ECIRS) for large renal stones and compares the results of a propensity score-matched cohort of patients undergoing shock-wave lithotripsy (SWL). @*Materials and Methods@#A total of 100 adults underwent ECIRS for renal stones between August 2017 and January 2019. For comparison, 2172 patients who underwent a first session of SWL between January 2005 and May 2018 were included in the SWL cohort.Propensity score matching was performed using maximal stone length (MSL), mean stone density (MSD), and stone heterogeneity index (SHI) scores. Stone-free rate (SFR) and success rate were compared between ECIRS and SWL. @*Results@#In the ECIRS group, the mean MSL, mean MSD, and mean SHI were 28.7±15.2 mm, 1013.9±360.0 Hounsfield units (HU), 209.4±104.0 HU, respectively. The SFR was 70%, and the success rate was 82.0% in this group. Although the ECIRS group had larger, harder, and more homogeneous stones than the SWL group, ECIRS showed a higher SFR and success rate than SWL. After propensity-score matching, SFR and success rate remained higher with ECIRS than with SWL (both, p<0.001). In multivariate logistic regression, smaller stone size [odds ratio (OR): 0.947, 95% confidence interval (CI): 0.913–0.979, p=0.002] and lower Seoul National University Renal Stone Complexity score (OR: 0.759, 95% CI: 0.610–0.935, p=0.011) were independent predictors of successful ECIRS. @*Conclusion@#ECIRS showed a higher SFR and success rate than SWL for large renal stones. Smaller stone size and lower complexity of stones were associated with a higher likelihood of successful ECIRS.
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Purpose@#The purpose of this study is three-fold: 1) to evaluate factors influencing hearing aid (HA) satisfaction; 2) to provide a profile of HA satisfaction in daily life; and 3) to examine the reasons why people gave up using HAs. @*Materials and Methods@#Data for 1148 respondents were statistically analyzed and reported. @*Results@#In the study, age (β=-0.03, p<0.01), level of education (β=1.21, p<0.01), HA purchase price (β=1.50, p<0.01), bilateral amplification (β=1.23, p<0.01), wearing time (β=0.28, p<0.01), and HA fitting and fine tuning on a regular basis (β=1.71, p<0.01) significantly influenced HA satisfaction. In addition, the authors observed that the most satisfactory factors were clarity of sound (53.5%), people’s trust in their HA (61.7%), and listening from a quiet environment (72.8%) in the domains of sound quality, HA features, and listening environments, respectively. Finally, with multiple choices being possible, 65% of the 40 respondents who no longer used HAs answered that their HAs ended up in a drawer since the background noise was annoying and distracting. @*Conclusion@#This study is significant in that it is a large-scale multi-center research to comprehensively examine the factors influencing HA satisfaction in South Korea. This data will provide helpful information that could lead to the successful rehabilitation of hearing loss with HAs.
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Background@#Hearing loss (HL) is the most common chronic disease and has been linked to negative health outcomes. Hearing aids (HAs) are regarded as the gold standard for HL management, however, the adoption rate of HAs is relatively low for various reasons. With this background, hearing devices, such as personal sound amplification products (PSAPs) received significant attention as an alternative to conventional HAs. This study aimed to evaluate the clinical efficacy of PSAPs in patients with mild to moderately severe HL. @*Methods@#Nineteen patients with mild hearing loss (MHL), 23 with moderate hearing loss (MDHL), and 15 with moderately severe hearing loss (MSHL) participated in the study.Electroacoustic analysis, simulated real-ear measurements (REMs), and three clinical evaluations were implemented. @*Results@#All devices satisfied the electroacoustic tolerances. All devices provided sufficient gain for MHL and MDHL audiograms. However, in MSHL audiogram, the gains of PSAPs were insufficient, especially for high frequencies. In terms of clinical evaluations, soundfield audiometry showed significant improvements between aided and unaided thresholds in all groups for all devices (P < 0.001). Significant improvements of word recognition scores were only shown for HAs between aided and unaided conditions. The Korean version of the Hearing In Noise Test did not show any consistent findings for all devices and groups. @*Conclusion@#Certain PSAPs are beneficial for improving hearing and speech perception in patients with HL. Well-chosen PSAPs could be an alternative hearing rehabilitation option for these patients.
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Background@#The aim of this study is to investigate the clinical effectiveness of Ponto in Korea, a recently released percutaneous bone-anchored hearing implant. @*Methods@#16 patients with single-sided deafness (SSD) and mixed or conductive hearing loss who underwent Ponto implantation from December 2018 to September 2020 were enrolled in the study. Puretone audiometry, the Korean version of the Hearing in Noise Test (K-HINT), sound localization test (SLT), and Pupillometry were performed pre- and three months post-operation. Standardized questionnaires, the Hearing Handicap Inventory for the Elderly (HHIE) and Speech, Spatial and Qualities of Hearing Scale (SSQ), were administered. @*Results@#The mean age of subjects was 55.5 (range, 48–67) years. Four males and 12 females participated in the study. The mean puretone average was 73.17 dB hearing level (HL) before surgery and significantly improved to 36.72 dB HL three months after surgery. The mean word recognition score improved from 26.0% to 90.75% after implantation. In the case of K-HINT, there was a significant difference in summation (Z = −2.250, P = 0.024) and head shadow effects (Z = −3.103, P = 0.002). There was no significant difference in root mean square error degree (RMSE) and hemifield identification scores for SLT testing. Pupillometry was performed to measure listening effort and the results revealed that the degree of pupillary dilatation decreased under the condition of quiet, 0 dB signal to noise ratio (SNR) and 3 dB SNR. The total score for HHIE decreased significantly (Z = −3.130, P = 0.002) while the SSQ score increased significantly (Z = −2.216, P = 0.027). @*Conclusions@#The Ponto bone-anchored hearing system showed significant clinical benefit in Korean patients with conductive and mixed hearing loss and SSD.
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The market for hearing technology is evolving—with the emergence of hearables, it now extends beyond hearing aids and includes any ear-level devices with wireless connectivity (i.e., wireless earbuds). However, will this evolving marketplace bring forth opportunities or challenges to individuals’ hearing health care and the profession of audiology and otolaryngology? The debate has been ongoing. This study explores the wide spectrum of hearables available in the market and discusses the necessity of high-quality clinical evidence prior to the implementation of over-the-counter devices into clinical practice.
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Objectives@#. This study was conducted to investigate the electroacoustic characteristics of personal sound amplification products (PSAPs), to identify whether PSAPs provide adequate gain and output for three common hearing loss (HL) configurations, and to compare the benefits of a representative PSAP (RPSAP) and a conventional hearing aid (HA) for clinical hearing outcomes as a pilot study. @*Methods@#. The study comprised three phases: electroacoustic analysis, simulated real-ear measurements (REMs), and clinical hearing experiments. Electroacoustic analysis and simulated REMs were performed for three basic PSAPs (BeethoSOL, EarJJang, and Geniesori2) and three high-end PSAPs (Hearing Able, Olive Smart Ear, and SoriIn) using the Aurical Hearing Instrument Test box with a 2-mL coupler. Four electroacoustic characteristics (maximum output sound pressure level at 90 dB SPL, frequency range, equivalent input noise, and total harmonic distortion) were investigated. By simulated REMs, appropriate levels of the six PSAPs for three common HL configurations (mild-to-moderate high-frequency HL, moderate to moderately severe sloping HL, and moderate flat HL) were determined. Clinical experiments compared the performance of RPSAP to HA, both of which were fitted by audiologists using REMs. Clinical experiments were administered using functional gain, a word recognition test, and the Korean version of the Hearing in Noise Test in six participants with bilateral moderate sensorineural HL. @*Results@#. The two high-end devices met all tolerances. One basic and two high-end PSAPs showed appropriate levels for three common HL configurations. In the clinical experiments, the RPSAP showed better performance than unaided, but slightly worse than HA under all test conditions. @*Conclusion@#. Certain PSAPs met all specified tolerances for electroacoustic analysis and approximated prescriptive targets in well-controlled laboratory conditions. The pilot clinical experiments explored the possibility that the RPSAP could serve as a hearing assistive device for patients with moderate HL.
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Objectives@#. This study was conducted to evaluate the user satisfaction, efficacy, and safety of round window (RW) vibroplasty using the Vibrant Soundbridge (VSB) in patients with persistent mixed hearing loss after mastoidectomy. @*Methods@#. The study included 27 patients (mean age, 58.7 years; age range, 28–76 years; 11 men and 16 women) with mixed hearing loss after mastoidectomy from 15 tertiary referral centers in Korea. The VSB was implanted at the RW. The Korean translation of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire were used to evaluate user satisfaction as the primary outcome. The secondary outcome measures were audiological test results and complication rates. @*Results@#. The mean scores for ease of communication (61.3% to 29.7% to 30.2%), reverberation (62.1% to 43.1% to 37.4%), and background noise (63.3% to 37.7% to 34.3%) subscales of the APHAB questionnaire significantly decreased after VSB surgery. The mean K-IOI-HA scores at 3 and 6 months after surgery were significantly higher than the mean preoperative score (18.6 to 27.2 to 28.1). The postoperative VSB-aided thresholds were significantly lower than the preoperative unaided and hearing aid (HA)-aided thresholds. There was no significant difference between preoperative unaided, preoperative HA-aided, and postoperative VSB-aided maximum phonetically balanced word-recognition scores. None of the 27 patients experienced a change in postoperative bone conduction pure tone average. One patient developed temporary facial palsy and two developed surgical wound infections. @*Conclusion@#. RW vibroplasty resulted in improved satisfaction and audiological test results in patients with mixed hearing loss after mastoidectomy, and the complication rate was tolerable.
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Background@#Dulaglutide, a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), has been shown to reduce body weight and liver fat content in patients with type 2 diabetes. Family with sequence similarity 3 member A (FAM3A) plays a vital role in regulating glucose and lipid metabolism. The aim of this study was to determine the mechanisms by which dulaglutide protects against hepatic steatosis in HepG2 cells treated with palmitic acid (PA). @*Methods@#HepG2 cells were pretreated with 400 μM PA for 24 hours, followed by treatment with or without 100 nM dulaglutide for 24 hours. Hepatic lipid accumulation was determined using Oil red O staining and triglyceride (TG) assay, and the expression of lipid metabolism-associated factor was analyzed using quantitative real time polymerase chain reaction and Western blotting. @*Results@#Dulaglutide significantly decreased hepatic lipid accumulation and reduced the expression of genes associated with lipid droplet binding proteins, de novo lipogenesis, and TG synthesis in PA-treated HepG2 cells. Dulaglutide also increased the expression of proteins associated with lipolysis and fatty acid oxidation and FAM3A in PA-treated cells. However, exendin-(9-39), a GLP-1R antagonist, reversed the expression of FAM3A, and fatty acid oxidation-associated factors increased due to dulaglutide. In addition, inhibition of FAM3A by siRNA attenuated the reducing effect of dulaglutide on TG content and its increasing effect on regulation of fatty acid oxidation. @*Conclusion@#These results suggest that dulaglutide could be used therapeutically for improving nonalcoholic fatty liver disease, and its effect could be mediated in part via upregulation of FAM3A expression through a GLP-1R-dependent pathway.
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Background@#Prevailing insulin regimens for glycemic control in hospitalized patients have changed over time. We aimed to determine whether the current basal-bolus insulin (BBI) regimen is superior to the previous insulin regimen, mainly comprising split-mixed insulin therapy. @*Methods@#This was a single tertiary center, retrospective observational study that included non-critically ill patients with type 2 diabetes mellitus who were treated with split-mixed insulin regimens from 2004 to 2007 (period 1) and with BBI from 2008 to 2018 (period 2). Patients from each period were analyzed after propensity score matching. The mean difference in glucose levels and the achievement of fasting and preprandial glycemic targets by day 6 of admission were assessed. The total daily insulin dose, incidence of hypoglycemia, and length of hospital stay were also evaluated. @*Results@#Among 244 patients from each period, both fasting glucose (estimated mean±standard error, 147.4±3.1 mg/dL vs. 129.4±3.2 mg/dL, P<0.001, day 6) and preprandial glucose (177.7±2.8 mg/dL vs. 152.8±2.8 mg/dL, P<0.001, day 6) were lower in period 2 than in period 1. By day 6 of hospital admission, 42.6% and 67.2% of patients achieved a preprandial glycemic target of <140 mg/dL in periods 1 and 2, respectively (relative risk, 2.00; 95% confidence interval, 1.54 to 2.59), without an increased incidence of hypoglycemia. Length of stay was shorter in period 2 (10.23±0.26 days vs. 8.70±0.26 days, P<0.001). @*Conclusion@#BBI improved glycemic control in a more efficacious manner than a split-mixed insulin regimen without increasing the risk of hypoglycemia in a hospital setting.
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Coronavirus causes an infectious disease in various species and crosses the species barriers leading to the outbreak of zoonotic diseases. Due to the respiratory diseases are mainly caused in humans and viruses are replicated and excreted through the respiratory tract, the nasal fluid and sputum are mainly used for diagnosis. Early diagnosis of coronavirus plays an important role in preventing its spread and is essential for quarantine policies. For rapid decision and prompt triage of infected host, the immunochromatographic assay (ICA) has been widely used for point of care testing. However, when the ICA is applied to an expectorated sputum in which antigens are present, the viscosity of sputum interferes with the migration of the antigens on the test strip. To overcome this limitation, it is necessary to use a mucolytic agent without affecting the antigens. In this study, we combined known mucolytic agents to lower the viscosity of sputum and applied that to alpha and beta coronavirus, porcine epidemic diarrhea virus (PEDV) and Middle East respiratory syndrome coronavirus (MERS-CoV), respectively, spiked in sputum to find optimal pretreatment conditions. The pretreatment method using tris(2-carboxyethyl)phosphine (TCEP) and BSA was suitable for ICA diagnosis of sputum samples spiked with PEDV and MERS-CoV. This sensitive assay for the detection of coronavirus in sputum provides an useful information for the diagnosis of pathogen in low respiratory tract.
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Objectives@#. The aim of this study was to investigate the current university admission rate and experiences of educational support among students with cochlear implants (CIs) in South Korea. @*Methods@#. A prospective online survey was conducted to examine the university admission process and academic support for students with CIs. Thirty individuals who took the college entrance exams at least 3 years after CI surgery were invited to participate, although two did not respond. The survey consisted of three topics (demographics, university admission process, and academic support) and 25 items regarding laws and policies related to university admission and support for students with hearing disabilities in Korea. @*Results@#. The university matriculation rate for students with CI was 85.7% (24/28), of whom 50% were admitted through the special admission process for students with disabilities. Most universities provided teaching and learning support and rental services for assistive devices for students with disabilities to help them better adapt to school life. However, only a small percentage of the students benefited from accommodation services, and 62.5% and 12.5% of the students received teaching and learning support and used assistive devices, respectively. @*Conclusion@#. To the best of our knowledge, this is the first study to investigate the university admission process and university disability services for students with CIs in South Korea. The results of this study will be helpful for young CI recipients and their parents as they prepare for university entrance.
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Objectives@#：This study aimed to investigate quality of life, severity of depression, suicidality, subjective health and subjective stress of depression with subjective cognitive decline in Korean adults. @*Methods@#：We used the 7th KNHANES data to enroll 415 participants with a score of 10 or higher on Patient Health Questionnaire-9 (PHQ-9), aged 20-64. Depression was divided into two groups based on the presence/absence of subjective cognitive decline. Demographic and psychological characteristics were compared between two groups. Correlation analysis of subjective cognitive decline, quality of life, depression, suicidal idea was car-ried out. To detect which variables influenced quality of life, a multiple regression analysis was carried out. @*Results@#：Among the 415 participants, 98 had depression with subjective cognitive decline. We identified sig-nificant differences in age, marital status, education, employment between the two groups. After adjusting for these variables, depression with subjective cognitive decline had lower EuroQol-5D index scores, more severe depressive symptoms without cognition and worse subjective health than depression without cognitive decline. There was a significant correlation between subjective cognitive decline and quality of life (r=-0.236, p<0.001), suicidal idea (r=0.182, p<0.001), depression score without cognition (r=0.108, p=0.028). Through multiple regression analysis, subjective cognitive decline was predictor of reduced quality of life (β=-0.178, p<0.001). @*Conclusions@#：Depression with subjective cognitive decline has poor quality of life and severe depression. Cognitive decline should be considered to improve treatment result in depression.
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Objectives@#：This study aimed to compare the characteristics of suicide attempts among Korean patients with mixed and non-mixed depression. @*Methods@#：Patients who visited the emergency room due to a suicide attempt and participated in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were included. Using the Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS), 111 patients were classified into the mixed depression (n=46) and non-mixed depression groups (n=65). The Koukopoulos Mixed Depression Rating Scale (KMDRS) score was calculated using the MADRS and YMRS scores. Suicide attempt characteristics were evaluated using the Columbia Suicidal Severity Rating Scale (C-SSRS) and Suicide Intent Scale (SIS). @*Results@#：In the mixed depression group, the reason item among the ideation intensity score of the C-SSRS was higher, and the deterrent item score was lower. Scores on the timing and suicide note items of the SIS were higher, and scores for overt communication items were lower in the mixed depression group. The KMDRS score was positively correlated with the C-SSRS ideation intensity and total SIS score. After adjusting for additional variables,the KMDRS scores had a significant effect on the C-SSRS ideation intensity and total SIS scores. @*Conclusions@#：The mixed depression group showed a difference in the intensity of suicidal ideation and suicidal intention compared to those in the non-mixed depression group. The overall suicidal ideation intensity and suicidal intention increased according to the degree of mixed depression.