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Background and Objectives The aim of this study was to assess the effect of wearing face masks on communication according to hearing levels using a questionnaire.Subjects and Method Individuals who underwent pure-tone audiometry at the otolaryngology department were invited to participate from September to December 2021. Each participant was asked to answer a questionnaire consisting of visual analog scales and open-ended questions about the experience of interactions involving face masks and the impact wearing face masks had on communication regarding listening, speaking and emotional exchange. The items of questionnaires were analyzed according to their hearing levels.Results A total of 119 subjects completed the questionnaire. The mean age of the subjects was 57.13±17.43 and the mean hearing threshold was 39.31±22.52 dB HL. Among them, 15.1% wore hearing aids. Across subjects, from those with the normal hearing level to those with moderate hearing loss, the average scores for subjective listening and speaking difficulty during conversation were significantly higher when individuals were wearing face masks than when they were not (p

Background and Objectives Dizziness has diverse underlying causes, so the diagnosis is challenging especially in the emergency room. The aim of this study is to identify clinical characteristics of patients’ complaints of dizziness in the emergency room.Subjects and Method We retrospectively reviewed the medical records of 10367 patients who visited the emergency room with the chief complaint of dizziness from January 2016 to December 2020. Patients’ clinical information including age, sex, final diagnoses, consulting departments, treatment results and seasonal incidences were thoroughly assessed. Results Of the total patients who visited the emergency room, 4.64% complained of dizziness. The mean age of patients was 57.6 years old. The most common age group was over 70’s (28.1%). There were 6322 (61.1%) female patients, while 4035 (38.9%) were male patients. Nearly half 4932 (47.6%) of the patients were managed by the emergency department, followed by 3204, who were managed by the department of otolaryngorhinology (30.9%), and 1166 (11.2%) managed by the neurology department. The dizziness was classified as peripheral vertigo (33.8%), nonspecific dizziness (27.4%), medical conditions (13.9%), central dizziness (11.0%), cardiac dizziness (6.2%), and other miscellaneous causes of trauma, neoplasm and psychogenic causes (7.7%). In peripheral vertigo, the incidence of BPPV, vestibular neuritis and Meniere’s disease were 23.5%, 8.8% and 0.6%, respectively. ConclusionPeripheral vertigo accounted for the majority for the patients with chief complaints of dizziness in the emergency room. As diverse medical conditions may cause dizziness, specialized departments have to be involved in the diagnostic process of dizziness.

This study evaluated the association between subjective cognitive decline (SCD) and the quality of life (QoL).This nation-wide cross-sectional study investigated 177,882 adults (78,362 men, 99,520 women) who participated in the 2019 Korean Community Health Survey. Multiple sociodemographic and psychosocial variables were evaluated and compared between participants with (n = 37,614) and without SCD (n = 140,518); the Patient Health Questionnaire-9 (PHQ-9) was used to determine the presence of depression and QoL was assessed using the EuroQol five-dimension (EQ-5D) questionnaire.Depression as defined by PHQ-9 scores ≥ 10 was reported significantly more often in the SCD group (9.2%) than in the non-SCD group (1.7%) (p 0.001). The mean EQ-5D index scores were significantly lower in the SCD group (score 0.83) than in the non-SCD group (score 0.90; p 0.001). The multivariate odds ratio (OR) for depression (PHQ9 ≥ 10) was3.11 (95% confidence interval [CI], 3.10-3.13) and the lowest quartile of the EQ-5D index scores was 1.88 (95% CI, 1.88-1.89) in the SCD group versus that in the non-SCD group. Participants in the SCD group were more likely to be physically active (OR, 1.32; 95% CI, 1.20-1.33) and have self-control (OR, 1.36; 95% CI, 1.34-1.37), daily activity (OR, 1.35; 95% CI, 1.33-1.36), pain (OR, 1.56; 95% CI, 1.56-1.57), and anxiety/depression (OR, 2.71; 95% CI, 2.68-2.73).Subjective cognitive decline is associated with depression and impaired quality of life, particularly if anxiety/depression is present.

The aim of this study is to identifying post treatment recurrence rates in pneumothorax patients under 35 and without any comorbidities according to the treatment types, gender, and age categories based on nationwide population data. Clinical information of pneumothorax patients was extracted from the Korean National Health Insurance Service (NHIS) database between January 2002 and December 2020. Enrolled patients were categorized into two groups; (1) Group I, those who underwent conservative management including pain relief, oxygen therapy, and closed thoracostomy, and (2) Group II, surgical intervention. Recurrence rates were compared according to age, gender, and type of treatment. Surgical intervention was performed in 25.6% patients as first treatment. The overall recurrence rate was 20.3%. Male patients showed a higher 5-year recurrence rate than female (20.8% vs. 10.9%, p

More people use the internet for medical information, especially YouTube. Nevertheless, no study has been conducted to analyze the quality of YouTube videos about tinnitus in Korea. This study aims to review the contents and quality of YouTube videos on tinnitus. The top 100 Korean YouTube videos on tinnitus were reviewed by a tinnitus expert. This study assessed video details: title, creator, length, and popularity indicators - subscribers, views, and likes. The contents of the video clips were analyzed to determine the relevant information they contained, and their understandability and actionability scores were also assessed. Out of 100 tinnitus videos, 27 were created by otolaryngologists, 25 by Oriental medicine doctors, 25 by other medical professionals, and 3 by lay persons. Sensorineural tinnitus was frequently dealt, and hearing loss, stress, and noise were introduced as main causes of tinnitus. Otolaryngologists' videos covered verified treatments, but others suggested unproven therapies including herbal medicine or acupressure. Otolaryngologists' videos had higher understandability than Oriental doctors (p = 0.003) and other medical professionals (p

Asthma is known to be associated with a variety of psychological disorders, such as anxiety, but the association between adolescent asthma and anxiety has not been investigated in detail.We analyzed 2,322 physician-diagnosed adolescent asthma patients and 38,696 non-asthmatic adolescent participants from the 2020 Korean Youth Risk Behavior self-administered Survey. Anxiety status was assessed using the Generalized Anxiety Disorder-7 (GAD-7) questionnaires. Multiple logistic regression analyses with complex sampling was performed with adjustments for multiple confounding variables (socioeconomic, health behavior, and psychological factors) to explore the association between GAD-7 scores and adolescent asthma.The asthma group had higher rates of anxiety (GAD-7 score ≥ 10) than the non-asthma group (5.0% and 6.7%, respectively;Asthma is associated with an increased prevalence of anxiety in Korean adolescents.

Background: The purpose of this study was to compare 1-year clinical outcomes between patients who underwent a Nuss operation or vacuum bell therapy and to present vacuum bell therapy as a possible alternative treatment modality for patients who prefer non-surgical correction of pectus excavatum. Methods: We conducted a retrospective review of pectus excavatum patients who had undergone vacuum bell therapy for more than 1 year and examined patients who had undergone Nuss bar removal more than 1 year previously. The treatment outcomes were evaluated by comparing changes in the Haller index before and after treatment in both patient groups. Results: We included 57 patients in this study and divided them into 2 groups according to the type of treatment received. Both groups showed no significant difference in the post-treatment Haller index after 1 year of follow-up, although the Nuss operation group showed a greater change in the Haller index than the vacuum bell group. Conclusion: Although the Nuss operation is a well-established and effective treatment of choice to correct pectus excavatum, vacuum bell therapy showed comparable outcomes and could become an alternative treatment modality for select patients who prefer non-invasive treatment.

Video Video 1 Incision and port placement of 4 to 5 cm at the fifth or sixth intercostal space between the anterior and the midaxillary line. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 2 Dissection of the anterior mediastinal pleura and division of the superior pulmonary vein. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 3 Dissection of the apical mediastinal pleura and division of the anterior and apical branches of the pulmonary artery. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 4 Dissection and division of the anterior oblique fissure and division of the lingular branches of the pulmonary artery. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 5 Dissection and division of the interlobar fissure and the posterior branch of the pulmonary artery. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 6 Dissection and division of the left upper lobe bronchus. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 7 Lymph node dissection (subaortic, hilar, subcarinal, or inferior pulmonary ligament) and division of the inferior pulmonary ligament. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 8 Specimen retrieval. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext. Video 9 Chest tube placement. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.

Background Although the initial projection after primary nipple reconstruction is excellent, nipple projection gradually flattens in most cases due to multiple causes. Although various methods have been reported to rebuild the nipple after nipple flattening, the most effective method of secondary nipple reconstruction remains unknown. The aim of this study was to review our institution’s experiences with secondary nipple reconstruction. Methods We conducted a retrospective review from March 2012 to January 2019. We performed secondary nipple reconstruction if the primary reconstructed nipple height differed by more than 6 mm from the normal nipple height. We chose the method of nipple revision according to the degree of tissue scarring and the remaining nipple projection. Results We performed secondary nipple reconstruction on a total of 27 nipples, using pursestring sutures for 19 nipples and star flaps in eight nipples. The median follow-up period was 8 months (range, 6–19 months) after the final nipple reconstruction. Among the 19 nipples reconstructed using purse-string sutures, 10 (53%) demonstrated acceptable projection of more than 5 mm. Among the eight nipples reconstructed using star flaps, six (75%) showed acceptable projection of more than 5 mm. Most of the patients (73%) were satisfied (scores of 4 or 5) with the nipple reconstruction overall. Conclusions Few studies have presented favorable outcomes of secondary nipple reconstruction. When the star flap and purse-string suture methods were used depending on the remaining nipple height and scarring, appropriate projection could be achieved.

Sujin Lee,1 Jae Ho Chung,2 Ji Hyun Kim3 1Department of Neurology, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea; 2Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea; 3Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of KoreaCorrespondence: Ji Hyun KimDepartment of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Guro-dong Ro 148, Guro-gu, Seoul, 08308, Republic of KoreaTel +82 2 26263171Email jhkim.merrf@gmail.comPurpose: There are few large studies evaluating the association between sleep quality and the risk of falls. We aimed to determine the independent effect of poor sleep quality on an increased risk of falls using a large-sample dataset.Methods: We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey on 201,700 participants. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2499 fallers who have experienced at least one fall during the past 12 months and 199,201 non-fallers. Multivariable logistic regression was performed to identify sleep quality variables significantly associated with an increased risk of falls.Results: Fallers had poorer sleep quality (PSQI score > 5) and higher scores for global PSQI and individual PSQI components than did non-fallers (all p < 0.001). Multivariable logistic regression adjusted for potential confounders including socioeconomic, physical health-related, and mental health-related variables showed that an increased risk of falls was associated with poor sleep quality (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.19– 1.42). Subgroup analyses by age revealed that poor sleep quality was significantly associated with an increased risk of falls in all three adult age groups. Multivariable logistic regression using the seven PSQI components revealed that an increased risk of falls was associated with short sleep duration (OR 1.14, CI 1.09– 1.20), increased sleep disturbances (OR 1.30, CI 1.16– 1.46), and increased daytime dysfunctions (OR 1.21, CI 1.08– 1.13).Conclusion: Poor sleep quality caused by short sleep duration may be a principal risk factor of falls in adult populations. Increased sleep disturbances and daytime dysfunctions may also contribute to an increased risk of falls. Our results have clinical and public health perspectives that increasing sleep duration and reducing daytime dysfunctions and sleep disturbances could mitigate unintentional falls.Keywords: falls, sleep quality, Pittsburgh sleep quality index

BACKGROUND Vascularized lymph node transfer (VLNT) is a well-established surgical approach for treating lower extremity lymphedema (LEL). Since VLNT takes time to show effect, a combined approach with lymphaticovenular anastomosis (LVA) may be more advantageous to patients by inducing an immediate improvement. This study aims to describe our experience and evaluate the results of a combined approach. METHODS In this retrospective review, we analyzed a total of 12 patients that underwent simultaneous supraclavicular VLNT and LVA for the treatment of secondary LEL with the ISL stage II or III. Patients who had a follow-up period of less than 12 months were excluded. The supraclavicular flap, including superficial lymphoid tissue as well as deep cervical nodes, was harvested and anastomosed to the posterior tibial vessels. The pre- and postoperative change of circumference difference ratios and LEL index were compared. RESULTS All twelve flaps survived without re-exploration. An average of 2.3 LVAs were simultaneously performed. At 12.9 months of follow-up (range, 12-16 months), the postoperative mean circumference ratio was significantly improved than pre-operative in 10 cm above the knee (7.9 ± 7.2% vs 15.0 ± 7.6%, p = 0.01), 10 cm below the knee (8.5 ± 7.5% vs 17.4 ± 12.7%, p = 0.03) and lateral malleolus (16.5 ± 15.5% vs 28.6 ± 17.9%, p = 0.03). Also, the mean LEL index was decreased (preoperative 324.3 ± 53.0 vs postoperative 298.0 ± 44.6, p = 0.242) and eight patients showed improvement in LEL stage. CONCLUSIONS The combined approach showed a significant decrease in the circumference of LEL. Additional LVAs could reinforce the effect of a VLNT. Larger series with longer follow-up is needed to confirm our findings.

This study aimed to evaluate the association between sleep quality and quality of life (QoL).This cross-sectional study included 225,541 adults (101,133 men, 124,408 women) who participated in the 2018 Korean Community Health Survey. Multiple sociodemographic and psychosocial variables were evaluated and compared between participants with poor (n = 67,619) and good sleep quality (n = 157,922); sleep quality was subjectively determined using the Pittsburgh Sleep Quality Index (PSQI). The EuroQol five-dimension (EQ-5D) index scores were adjusted for multiple confounding factors and compared between the good and poor sleep quality groups. A logistic regression analysis was used to identify determinants of the lowest quartile of QoL.The mean EQ-5D index scores were significantly lower in the poor sleep quality group (score 0.85) than in the good sleep quality group (score 0.92; p 0.001). The multivariate odds ratio (OR) for the lowest quartile of the EQ-5D index scores in the poor sleep quality group versus that in the good sleep quality group was 1.95 (95% confidence interval [CI], 1.89-2.00). Participants with poor sleep quality were more likely than those with good sleep quality to have some or severe problems with physical activity (OR, 1.46; 95% CI, 1.41-1.51), self-control (OR, 1.35; 95% CI, 1.29-1.42), daily activity (OR, 1.44; 95% CI, 1.39-1.50), pain (OR, 1.81; 95% CI, 1.77-1.86), and anxiety/depression (OR, 2.24; 95% CI, 2.17-2.31).Poor sleep quality is associated with impaired QoL, particularly if some or severe problems with anxiety/depression are present.

OBJECTIVES: Research is lacking on the impacts of exposure to particulate matter (PM) and air pollution on patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, we investigate the effects of various air pollution factors on hospitalization for asthma and COPD. METHODS: We obtained data on pollutants—PM(10), PM(2.5), carbon monoxide (CO), ozone (O(3)), nitrogen dioxide (NO(2)), and sulfur dioxide (SO(2))—in Gyeonggi-do, South Korea. We also extracted data from Korean National Health Insurance records and investigated asthma and COPD attacks that required hospitalization from January 2007 through February 2018. We used generalized additive models with Poisson distribution and log transformation to calculate adjusted risk. A time-stratified case-crossover design was used, and conditional logistic regression was performed to analyze these data. RESULTS: Per-unit increases in concentrations of PM(10), PM(2.5), SO(2), NO(2), CO, and O(3) on different best lag days were associated with increased risks for hospital admission for COPD and asthma. SO(2) had the strongest effect on hospital admission for asthma (odds ratio [OR], 1.535; 95 % confidence interval [CI], 1.450–1.619). SO(2) also had the strongest effect on hospital admission for COPD (OR, 1.659; 95 % CI, 1.541–1.786). Subgroup analyses showed that these relationships were stronger in seniors (≥ 65 years old) and women with asthma than in men and nonseniors with COPD. CONCLUSIONS: Short-term exposure to PM(10), PM(2.5), CO, O(3), NO(2), and SO(2) may result in hospitalization for asthma and COPD. Of these pollutants, SO(2) has the strongest effects. Therefore, patients with COPD and asthma should be cautioned against performing outdoor activities when SO(2) levels are high.