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Background@#Many studies have examined the perception of musical emotion using excerpts from familiar music that includes highly expressed emotions to classify emotional choices.However, using familiar music to study musical emotions in people with acquired hearing loss could produce ambiguous results as to whether the emotional perception is due to previous experiences or listening to the current musical stimuli. To overcome this limitation, we developed new musical stimuli to study emotional perception without the effects of episodic memory. @*Methods@#A musician was instructed to compose five melodies with evenly distributed pitches around 1 kHz. The melodies were created to express the emotions of happy, sad, angry, tender, and neutral. To evaluate whether these melodies expressed the intended emotions, two methods were applied. First, we classified the expressed emotions of melodies with selected musical features from 60 features using genetic algorithm-based k-nearest neighbors.Second, forty-four people with normal hearing participated in an online survey regarding the emotional perception of music based on dimensional and discrete approaches to evaluate the musical stimuli set. @*Results@#Twenty-four selected musical features produced classification for intended emotions with an accuracy of 76%. The results of the online survey in the normal hearing (NH) group showed that the intended emotions were selected significantly more often than the others. K-means clustering analysis revealed that melodies with arousal and valence ratings corresponded to representative quadrants of interest. Additionally, the applicability of the stimuli was tested in 4 individuals with high-frequency hearing loss. @*Conclusion@#By applying the individuals with NH, the musical stimuli were shown to classify emotions with high accuracy, as expressed. These results confirm that the set of musical stimuli can be used to study the perceived emotion in music, demonstrating the validity of the musical stimuli, independent of innate musical bias such as due to episodic memory.Furthermore, musical stimuli could be helpful for further studying perceived musical emotion in people with hearing loss because of the controlled pitch for each emotion.
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Purpose@#Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. @*Materials and Methods@#We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period. @*Results@#Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. @*Conclusions@#During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.
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This study explores the internal standards for hearing tests and benefits of implementing international standard protocols, including the International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC), and discusses how ISO and IEC standards provide a framework for designing, calibrating, assessing hearing test instruments and methods, and exchanging and comparing data globally. ISO and IEC standards for hearing tests improve accuracy, reliability, and consistency of test results by applying standardized methods and environments. Moreover, they promote international harmonization and data interoperability, enabling information exchange and research collaboration. Those standards for hearing tests are beneficial but have challenges and limitations, such as variation in equipment and calibration, lag in updating standards, variation in implementation and compliance, and lack of coverage of clinical aspects, cultural diversity, and linguistic diversity. These affect the quality and interpretation of test results. Adapting ISO or IEC standards locally would improve their applicability and acceptability, while balancing customization and compatibility with global standards.
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Objectives@#. To train participants to localize sound using virtual reality (VR) technology, appropriate auditory stimuli that contain accurate spatial cues are essential. The generic head-related transfer function that grounds the programmed spatial audio in VR does not reflect individual variation in monaural spatial cues, which is critical for auditory spatial perception in patients with single-sided deafness (SSD). As binaural difference cues are unavailable, auditory spatial perception is a typical problem in the SSD population and warrants intervention. This study assessed the applicability of binaurally recorded auditory stimuli in VR-based training for sound localization in SSD patients. @*Methods@#. Sixteen subjects with SSD and 38 normal-hearing (NH) controls underwent VR-based training for sound localization and were assessed 3 weeks after completing training. The VR program incorporated prerecorded auditory stimuli created individually in the SSD group and over an anthropometric model in the NH group. @*Results@#. Sound localization performance revealed significant improvements in both groups after training, with retained benefits lasting for an additional 3 weeks. Subjective improvements in spatial hearing were confirmed in the SSD group. @*Conclusion@#. By examining individuals with SSD and NH, VR-based training for sound localization that used binaurally recorded stimuli, measured individually, was found to be effective and beneficial. Furthermore, VR-based training does not require sophisticated instruments or setups. These results suggest that this technique represents a new therapeutic treatment for impaired sound localization.
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Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) is a rare subtype of renal cell carcinoma that has a favorable outcome. Most cases of MCRNLMP usually present as distinct multilocular cystic lesions; however, they may appear as small complicated cysts with hemorrhagic components. Herein, we present a case of MCRNLMP and provide a review of the literature.
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Purpose@#This study aimed to systematically evaluate the content and effect of using Korean mobile apps for mental health care as reported in previous studies. @*Methods@#We conducted a systematic review according to PRISMA guidelines. Randomized controlled trials published up to May 2021 were searched in the PubMed, Cochrane Library, EMBASE, CINAHL, PsycINFO, RISS, KISS, and KoreaMed databases. We used the Cochrane risk-of-bias tool version 2 for randomized trials to evaluate the selected studies. @*Results@#Out of 3,374 articles retrieved, 12 were selected. These studies included people with mental disorders (mood disorder, panic disorder, or obsessive-compulsive disorder), psychiatric symptoms (depression, anxiety, attention deficit, etc.), and people in specific groups (college students or nurses). The apps were based on cognitive-behavioral therapy, cognitive training, well-being cognition technique, or relaxation techniques. The apps were effective in reducing depression, anxiety, panic attacks, attention deficit, negative emotions, and dysfunctional attitudes, and boosting memory and positive emotions. @*Conclusion@#Mobile apps with well-established, theory-based content can serve as an effective intervention for managing several mental health symptoms. However, the scope of the research subjects and symptoms in Korea remains limited. Further studies with more varied populations and symptoms are required.
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Objective@#Acute cholangitis is a clinical condition caused by infection of an obstructed biliary system, which is normally managed with intravenous fluids, antibiotics, and biliary drainage. Although endoscopic retrograde cholangiopancreatography (ERCP) is the preferred method of biliary drainage, guidelines for biliary drainage time remain unclear. @*Methods@#The current research is a retrospective study of patients with acute cholangitis who had undergone ERCP between January 2016 and December 2019. We investigated the effect of the time taken from visit to the emergency department and commencement of the ERCP, on hospital length of stay. @*Results@#A total of 441 patients were included in this study. No association was observed between the severity of acute cholangitis and ERCP time. However, the length of hospital stay was significantly shorter for patients who underwent ERCP less than 12 hours after arrival at the emergency department. @*Conclusion@#Conducting ERCP within 12 hours of arrival is associated with reduced hospital stays, regardless of the severity of acute cholangitis.
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Objectives@#With the rapid changes in society, there are more arguments for redefining dental education system. This study aimed to review and analyze the problems in the current dental education system in Korea and then propose an integrated education system based on those findings. @*Methods@#A narrative review of the problems confronting the dental education system in Korea was carried out. Accordingly, full-text screening and specialists’ discussions were extracted from the review. The purpose of the review was to summarize the strengths and weaknesses of Korean dental education systems to offer perspectives on an integrated education system in accordance with the specialists’ opinions. @*Results@#The results revealed that the problems of the current dental education system were identified in clinical education, basic science, and humanities and social sciences. Dental schools should provide clinical education so that dental students can be exposed to the clinical environment at an early stage and perform patient-based clinical practice. It is also imperative to encourage participation in research programs to train dental scientists, as well as to reflect on courses that can adapt to changes brought about by new technologies. It is recommended that education opportunities for integrated humanities and social sciences be provided. @*Conclusions@#It will be critical in the future for dental schools to embrace a flexible education system from various perspectives. It is vital that dental schools play a role in developing students’ critical thinking, problem-solving, and decision-making skills. Finally, as part of an integrated education system, an improvement program should be devised.
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Objectives@#With the rapid changes in society, there are more arguments for redefining dental education system. This study aimed to review and analyze the problems in the current dental education system in Korea and then propose an integrated education system based on those findings. @*Methods@#A narrative review of the problems confronting the dental education system in Korea was carried out. Accordingly, full-text screening and specialists’ discussions were extracted from the review. The purpose of the review was to summarize the strengths and weaknesses of Korean dental education systems to offer perspectives on an integrated education system in accordance with the specialists’ opinions. @*Results@#The results revealed that the problems of the current dental education system were identified in clinical education, basic science, and humanities and social sciences. Dental schools should provide clinical education so that dental students can be exposed to the clinical environment at an early stage and perform patient-based clinical practice. It is also imperative to encourage participation in research programs to train dental scientists, as well as to reflect on courses that can adapt to changes brought about by new technologies. It is recommended that education opportunities for integrated humanities and social sciences be provided. @*Conclusions@#It will be critical in the future for dental schools to embrace a flexible education system from various perspectives. It is vital that dental schools play a role in developing students’ critical thinking, problem-solving, and decision-making skills. Finally, as part of an integrated education system, an improvement program should be devised.
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Purpose@#We evaluated the risk factors for progression to chronic complicated bronchopleural fistula (BPF) after pulmonary resection using follow-up CT. @*Materials and Methods@#We retrospectively reviewed 45 cases with BPF that had undergone pulmonary resection during 2010-2018. We compared the clinical and radiological characteristics of those with complicated BPF (n = 24) and those without complicated (sterilized) BPF (n = 21). The clinical and radiological risk factors for progression to chronic complicated BPF were examined by logistic regression analysis. @*Results@#The thickness of the pleural cavity wall (p = 0.022), the size of the pleural cavity (p = 0.029), and the size increase of BPF on follow-up (p = 0.012) were significantly different between the two groups. The risk factors for progression to chronic complicated BPF were age > 70 years (odds ratio, 6.43; 95% confidence interval, 1.2–33.7), the thickness of the cavity wall > 5 mm (odds ratio, 52.5; 95% confidence interval, 5.1–545.4), and an increase in the size of the pleural cavity on follow-up CT (odds ratio, 12.5; 95% confidence interval, 2.1–73.5), only in the univariate analysis. @*Conclusion@#The risk factors for progression to chronic complicated BPF can be evaluated using follow-up CT.
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Background@#This study was a multicenter, parallel-group, double-blind, double-dummy, randomized, noninferiority trial to evaluate the efficacy and safety of γ-linolenic acid (GLA) relative to α-lipoic acid (ALA) over a 12-week treatment period in type 2 diabetes mellitus (T2DM) patients with painful diabetic peripheral neuropathy (DPN). @*Methods@#This study included 100 T2DM patients between 20 and 75 years of age who had painful DPN and received either GLA (320 mg/day) and placebo or ALA (600 mg/day) and placebo for 12 weeks. The primary outcome measures were mean changes in pain intensities as measured by the visual analogue scale (VAS) and the total symptom scores (TSS). @*Results@#Of the 100 subjects who initially participated in the study, 73 completed the 12-week treatment period. Per-protocol analyses revealed significant decreases in the mean VAS and TSS scores compared to baseline in both groups, but there were no significant differences between the groups. The treatment difference for the VAS (95% confidence interval [CI]) between the two groups was −0.65 (−1.526 to 0.213) and the upper bound of the 95% CI did not exceed the predefined noninferiority margin (δ1 =0.51). For the TSS, the treatment difference was −0.05 (−1.211 to 1.101) but the upper bound of the 95% CI crossed the noninferiority margin (δ2 =0.054). There were no serious adverse events associated with the treatments. @*Conclusion@#GLA treatment in patients with painful DPN was noninferior to ALA in terms of reducing pain intensity measured by the VAS over 12 weeks.
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Background@#The digits-in-noise (DiN) test is a speech-in-noise test to measure speech recognition threshold in noise adaptively. Herein, we aimed to develop the Korean version of the DiN test to provide a useful hearing screening tool for clinical as well as research purposes.Method: Spoken monosyllabic digits from 0 to 9 were recorded by a female speaker. The test list was constructed such that each digit was placed in three different positions. An optimization procedure was conducted to equate the audibility of each digit. After the optimization, the smartphone application for the Korean DiN (K-DiN) test was developed. For the adaptive measurement procedure, 180 new DiN triplets separated into six lists of 30 were created. Mean speech recognition threshold values for each list and session were measured to examine the test-retest and training effects of the test materials. In addition, speech recognition threshold values measured by different devices were compared to determine whether the speech recognition threshold levels differed. @*Results@#Optimization results showed that the mean speech recognition threshold and slope were −11.55 dB signal-to-noise ratio and 10.21%/dB, respectively, which are comparable to levels shown in different-language versions of the DiN test. The results of the test-retest and training effects revealed no significant differences among the test sessions and lists. Additionally, the mean speech recognition threshold values measured by four different devices were not different, indicating the reliability of the test materials. @*Conclusion@#We believe this study is the first to attempt to develop a K-DiN test. Our results indicate that this test can be used as a potentially reliable hearing screening tool.
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Objectives@#. Cochlear implant (CI) users typically report impaired ability to understand speech in noise. Speech understanding in CI users decreases with noise due to reduced temporal processing ability, and speech perceptual errors involve stop consonants distinguished by voice onset time (VOT). The current study examined the effects of noise on various speech perception tests while at the same time used cortical auditory evoked potentials (CAEPs) to quantify the change of neural processing of speech sounds caused by noise. We hypothesized that the noise effects on VOT processing can be reflected in N1/P2 measures, the neural changes relate to behavioral speech perception performances. @*Methods@#. Ten adult CI users and 15 normal-hearing (NH) people participated in this study. CAEPs were recorded from 64 scalp electrodes in both quiet and noise (signal-to-noise ratio +5 dB) and in passive and active (requiring consonant discrimination) listening. Speech stimulus was synthesized consonant-vowels with VOTs of 0 and 50 ms. N1-P2 amplitudes and latencies were analyzed as a function of listening condition. For the active condition, the P3b also was analyzed. Behavioral measures included a variety of speech perception tasks. @*Results@#. For good performing CI users, performance in most speech test was lower in the presence of noise masking. N1 and P2 latencies became prolonged with noise masking. The P3b amplitudes were smaller in CI groups compared to NH. The degree of P2 latency change (0 vs. 50 ms VOT) was correlated with consonant perception in noise. @*Conclusion@#. The effects of noise masking on temporal processing can be reflected in cortical responses in CI users. N1/P2 latencies were more sensitive to noise masking than amplitude measures. Additionally, P2 responses appear to have a better relationship to speech perception in CI users compared to N1.
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OBJECTIVES: This study aimed to propose criteria for evaluating the validity of dental education systems in Korea and suggest future directions for their improvement. METHODS: We looked into dental educational institutions and derived criteria for analysis and comparison of dental education systems in Korea. Using analytical methods, we compared the strengths and weaknesses of each education system, and suggested core areas of improvement. RESULTS: Considering the demands placed on the Korean dental education sector, it is desirable to have an integrated education system that includes the preliminary and main courses, comprehensive training linking the basic medicine and clinical practice, and complete career guidance. CONCLUSIONS: A good dental education system is one that meets the educational goals set by a dental school. If the goal is to train a student to be a good dental practitioner, a 2+4 or 4+4 system is recommended, while a 3+4 model is more suitable when the objective is to train students to be researchers.
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Humans , Education , Education, Continuing , Education, Dental , Korea , Schools, DentalABSTRACT
OBJECTIVES: Dentists and dental hygienists undergo high levels of stress due to various factors and the burnout of health-care personnel is very important in the context of personal and social problems. Therefore, empirical research reflecting the social, cultural, and special circumstances of the medical environment is necessary. Here, we explore the causes and outcomes of burnout in dentists and dental hygienists and present ways to prevent burnout. METHODS: A cross-sectional research design was used to measure burnout of 141 dentists and 61 dental hygienists. A structured questionnaire containing the Maslach Burnout Inventory (MBI) was administered from May to June, 2018. Data were analyzed using SPSS 25.0, descriptive statistics, t-test, Mann-Whitney test, Kruskall-Wallis test, and multiple regression analysis. RESULTS: Each participant's MBI was measured in three aspects (emotional exhaustion, depersonalization, and personal accomplishment). The MBI scores of dentists with regards to their emotional exhaustion, depersonalization, and personal accomplishment were 24.8%, 34%, and 48.2%, respectively. Alternatively the scores of dental hygienists were 45.9%, 44.3% and 52.5%, respectively, for the same parameters. While the factors affecting the burnout of dentists and dental hygienists were different, it had a negative impact on the professional performance of both. CONCLUSIONS: According to the results of this study, Korean dentists and dental hygienists experience high levels of work-related burnouts. This can have adverse impacts on their personal health and that of their patients. Therefore, stress management is necessary in dentists and dental hygienists.
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Humans , Dental Hygienists , Dentists , Depersonalization , Empirical Research , Research Design , Social ProblemsABSTRACT
BACKGROUND AND OBJECTIVES: Cochlear implant (CI) changes the way that sound inputs are processed in the brain, possibly causing brain reorganization. Given that the pattern and degree of reorganization are known to be related to speech perception skill, information regarding hemispheric asymmetry can be used to predict behavioral performances in CI users. The current study investigated the hemispheric asymmetry of N1 dipole cortical activity in response to the temporally varied speech sounds and its relationship to speech perception abilities in adult CI users. SUBJECTS AND METHOD: The cortical activity was recorded from 64 scalp electrodes in 10 CI users and 11 normal-hearing controls. Speech stimuli were synthesized consonant-vowels, the /ba/-/pa/ continuum that ranged from 0 to 50 ms with a 6-step voice onset time (VOT). N1 dipole amplitudes, latencies, and locations were analyzed as a function of VOT and the direction of implantation. Also investigated was the relationship between N1 dipole lateralization and speech perception. RESULTS: For the N1 dipole location, significant location differences between CI and normal hearing groups were seen at 40 ms VOT in the anterior-posterior direction. For hemispheric asymmetry, the N1 dipole activity in good CI performers was higher in the auditory cortex contralateral to the stimulated ear, while poor CI performers showed greater ipsilateral activity. In addition, a lateralization index at 20 ms VOT showed significant correlation with the /ba/-/pa/ consonant perception scores in noise. CONCLUSION: The results suggest that the hemispheric asymmetry of N1 dipole activity in response to stimuli of temporally varied speech has a substantial clinical value, and that this can be used to estimate CI speech perception.
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Adult , Humans , Auditory Cortex , Brain , Cochlear Implants , Ear , Electrodes , Hearing , Methods , Noise , Phonetics , Scalp , Speech Perception , VoiceABSTRACT
BACKGROUND AND OBJECTIVES@#Cochlear implant (CI) changes the way that sound inputs are processed in the brain, possibly causing brain reorganization. Given that the pattern and degree of reorganization are known to be related to speech perception skill, information regarding hemispheric asymmetry can be used to predict behavioral performances in CI users. The current study investigated the hemispheric asymmetry of N1 dipole cortical activity in response to the temporally varied speech sounds and its relationship to speech perception abilities in adult CI users.SUBJECTS AND METHOD: The cortical activity was recorded from 64 scalp electrodes in 10 CI users and 11 normal-hearing controls. Speech stimuli were synthesized consonant-vowels, the /ba/-/pa/ continuum that ranged from 0 to 50 ms with a 6-step voice onset time (VOT). N1 dipole amplitudes, latencies, and locations were analyzed as a function of VOT and the direction of implantation. Also investigated was the relationship between N1 dipole lateralization and speech perception.@*RESULTS@#For the N1 dipole location, significant location differences between CI and normal hearing groups were seen at 40 ms VOT in the anterior-posterior direction. For hemispheric asymmetry, the N1 dipole activity in good CI performers was higher in the auditory cortex contralateral to the stimulated ear, while poor CI performers showed greater ipsilateral activity. In addition, a lateralization index at 20 ms VOT showed significant correlation with the /ba/-/pa/ consonant perception scores in noise.@*CONCLUSION@#The results suggest that the hemispheric asymmetry of N1 dipole activity in response to stimuli of temporally varied speech has a substantial clinical value, and that this can be used to estimate CI speech perception.
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BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a widely used method for long-term tube feeding. This study aimed to investigate the clinical characteristics and outcomes of patients who utilized long-term feeding tube via PEG. METHODS: The medical records of 137 patients who underwent PEG tube insertion at Ewha Womans University Mokdong Hospital between January 2002 and December 2013 were reviewed. RESULTS: PEG was indicated most frequently for cerebrovascular accidents (66 patients, 48.2%), followed by head and neck cancer (20 patients, 14.6%), and Parkinson's disease (10 patients, 7.3%). The tubes were endoscopically inserted in 133 patients (97.1%); 4 patients (2.9%) underwent radiologic intervention. The tubes of 90 patients (65.7%) were exchanged at least once during the follow-up period. At the first exchange, 71 patients (78.9%) had their tubes exchanged by endoscopy, 24 patients (16.7%) by manually, and 4 patients (4.4%) by radiologic intervention. Of the 61 patients (44.5%) who had their tubes exchanged twice, 44 patients (72.1%) changed their tubes by endoscopic exchange, 13 patients (21.3%) by manually, and 4 patients (4.4%) via radiologic intervention. The mean time interval between the initial insertion and the first exchange was 9.83±6.19 months, and that between the initial insertion and the second exchange was 10.7±6.25 months. Of all the 137 patients, acute complications at initial insertion occurred in only 18 patients (13.1%), with insertion site infection (9 patients, 6.6%) being the most common acute complication. CONCLUSIONS: PEG appears to be a safe procedure for providing long-term tube feeding. Our results may help to develop strategies for further management of subjects receiving feeding tubes via PEG.
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Female , Humans , Endoscopy , Enteral Nutrition , Follow-Up Studies , Gastrostomy , Head and Neck Neoplasms , Medical Records , Methods , Observational Study , Parkinson Disease , StrokeABSTRACT
OBJECTIVES: This study was to examine the effectiveness of computerized cognitive ability enhancement program (CCAEP) using Smart-toy. The CCAEP using Smart-toy which can interact with children via bluetooth is a kids-friendly and convenient method for improving children's cognitive abilities by increasing their motivation for performing the program. We developed the CCAEP which designed to train auditory-verbal memory, visual-spatial memory, auditory-verbal working memory, and visual-spatial working memory. METHODS: Eighteen children aged 8 to 10 participated in CCAEP individual training composed of 8 sessions of 40 minutes each for 4 weeks. The effect of the training was measured with Smart Toyweb's cognitive assessment tasks (smart device based assessment) as well as traditional neuropsychological tests before and after the training. RESULTS: Children showed significant improvement in auditory-verbal memory, visual-spatial memory, auditory-verbal working memory and visual-spatial working memory abilities after the training. CONCLUSION: This study demonstrated promising results suggesting the effectiveness of CCAEP using Smart-Toy in clinical settings as well as school and home situations. Further controlled study with larger sample size including various clinical groups is needed to confirm the present results.
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Child , Humans , Memory , Memory, Short-Term , Methods , Motivation , Neuropsychological Tests , Sample SizeABSTRACT
Hepatocellular carcinoma is the third leading cause of cancer related mortality worldwide. Only 30% of patients are eligible for curative surgical resection at diagnosis. For patients with advanced hepatocellular carcinoma with accompanying portal vein tumor thrombosis, Sorafenib is recommended as first-line treatment. However, survival gain from sorafenib is unsatisfactory, and there is no standard therapy for patients who are intolerable or refractory to sorafenib. Here we report a case of a 52-year-old man who initially achieved partial response after sorafenib treatment, but eventually showed disease progression and was treated subsequently with transarterial chemoembolization (TACE). Multinodular recurrence occurred, but he was treated with repeated TACE, and has survived for 4 years so far.