Background: There is a strong correlation between risk factors for coronary artery disease (CAD) and aortic aneurysm (AA). We aimed to investigate the prevalence and prognostic impact of CAD and AA in patients who underwent coronary aorta computed tomography (CACT) protocol, which allowed simultaneous evaluation of coronary artery and aorta. Methods: Between 2010 and 2021, 1,553 patients who underwent CACT were enrolled from a tertiary center. The presence and location of AA and the presence of CAD were identified from CT. The primary outcome was a composite of cardiovascular death, acute coronary syndrome requiring urgent revascularization, and stroke at 3 years after the index CT scan. Results: Out of 1,553 enrolled patients, 179 (11.5%) had AA. The prevalence of CAD was significantly higher in patients with AA than those without (47.5% vs. 18.3%, P < 0.001). Among patients with AA, the prevalence of comorbid CAD was higher in those with abdominal AA than thoracic AA (57.3% vs. 37.8%, P = 0.014), respectively. In multivariable analysis, the presence of CAD was an independent predictor of primary outcome at 3 years (hazard ratio [HR], 2.58; 95% CI, 1.47–4.51; P = 0.001), while AA was not (HR, 1.00; 95% CI, 0.48–2.07; P = 0.993). Conclusion In this cohort of patients undergoing simultaneous evaluation of coronary artery and aorta using CACT protocol, patients with AA had an increased risk of comorbid CAD compared to those without AA. CAD was independently associated with adverse clinical outcomes at 3 years.

PURPOSE: It is important to know the accurate refractive error of the patients before LASIK because the amount of ablation is determined by that. We analyzed whether there are differences among the preoperative and postoperative results of cycloplegic retinoscopy (CR), module setting value, and autorefraction with and without cycloplegia (ACR, AMR). METHODS: The manifest and cycloplegic refractions of 104 eyes of 104 patients who underwent LASIK from February 2001 to July 2001 were reviewed. The preoperative and postoperative cycloplegic refraction, autorefraction by Canon RK-5, and module setting value were analyzed. RESULTS: In comparison of the preoperative values, AMR showed myopic shift compared to CR, module setting, and ACR (p<.001). ACR showed hyperopic shift compared to CR (p<0.001). The module setting showed myopic shift compared to CR, but it was not statistically significant. Postoperative mean spherical equivalent was 0.04 +/- 0.67D(range: -1.75 ~ +1.5). In comparison of the postoperative results, ACR showed hyperopic shift compared to CR (p<0.001) and AMR showed myopic shift compared to CR (p<0.001). CONCLUSIONS: As there is a difference between autorefraction and cycloplegic refraction, it is inappropriate to decide the amount of ablation only by one method. Hence when LASIK or LASIK retreatment is planned, cycloplegic refraction as well as autorefraction is necessary.
Humans ; Keratomileusis, Laser In Situ* ; Refractive Errors ; Retinoscopy ; Retreatment

OBJECTIVE: The purpose of this study is to investigate the effects of spouse support and conflict on the depression in older adults, and also to explore whether there are any differences between men and women in these effects. METHODS: The participants of this study were normal and married older adults who participated in the first wave of Korean Social Life, Health, and Aging Project. Participants consisted of 221 men and 210 women. The effects of support and conflict in spousal and other relationships on depression were analyzed using hierarchical regression analysis, separately in men and women. RESULTS: In the men group, the spouse conflict was especially influential in depression. More spouse conflict resulted in greater depression among men. In the women group, however, support from individuals other than spouse (kin support and friends support) had significant effects on depression. Less support received from individuals other than spouse was associated with higher levels of depression among women. CONCLUSION: The results of this study suggest that the quality of spousal and other relationships is related to depression in older adults. Moreover, there is a gender difference in the effect of support and conflict experienced in the relationship.
Adult* ; Aging ; Depression* ; Female ; Friends ; Humans ; Male ; Spouses*

OBJECTIVE: This study aimed to examine the effects of the social engagement (size of the social networks, social support, social conflict) by relationship types (spouse, family and kin, and neighbor and friends) on the cognitive functions of older adults in rural communities. METHODS: The participants of this study were normal older adults who participated in the first wave of the Korean Social Life, Health and Aging Project. Five hundred two older adults (men 218, women 284) aged 60 and over (mean age=71.44±6.81) participated. We analyzed the effects of different types of social engagement on Mini-Mental State Examination for Dementia Screening (MMSE-DS) performance using hierarchical multiple regression analysis. RESULTS: The result showed that, after controlling for the education level and age, the social support from the spouse, the conflict with neighbors or friends, the number of neighbors or friends significantly predicted MMSE-DS scores. These three variables accounted for additional 5.2% of the total variance of MMSE-DS. CONCLUSION: Our findings suggest that social engagement (network size, support, conflict) is associated with cognitive function among older adults. However, social engagement in different types of social relationship may contribute differently to cognitive function of older adults.
Adult* ; Aging ; Cognition ; Cognitive Aging ; Cognitive Reserve ; Dementia ; Education ; Female ; Friends ; Humans ; Mass Screening ; Rural Population ; Spouses

PURPOSE: This project was designed to study the effectiveness and safety of Dream lens(TM) (OK B+ series lenses, Contex, USA) in correcting myopia in a population of school children, under 13 years old. METHODS: Twenty-three school children aged 7 to 13 years followed over a 3-month period were fitted with lenses in the Vision Eye Center from September 2002 to March 2003. Slit lamp examination, uncorrected visual acuity, autorefraction and autokeratometry by Canon RK-5 and topography were measured at baseline and at 1week, 1 month, and 3 months after the lenses were worn. RESULTS: The mean baseline autorefraction was -2.54 +/- 1.00 diopters (range: -0.63~-4.00) and baseline uncorrected visual acuity over 0.5 was 11.1% and over 0.8 was 0%. Vision correction of over 0.8 was found in 80% of the cases in the first 1 week, 78% at 1 month, 91% at 3 months with the most rapid improvement occurring during the first 1 week. Superficial punctate keratitis occurred in 4 of 45 eyes, but there was no other pathologic problem. CONCLUSIONS: Dream lens is an effective and safe means of temporarily reducing myopia in a certain range of myopic patients; however, further studies are needed to determine the long-term effects on the eye health.
Adolescent ; Child* ; Humans ; Keratitis ; Myopia ; Visual Acuity

OBJECTIVE: The present study has examined whether subjective age would be associated with cognitive functioning in older adults. METHODS: Data from the third wave of Korean Social Life, Health, and Aging Project were used. This study was conducted with 152 older adults aged 60–89 years (mean=72.26, standard deviation=6.41) who completed measures of subjective age, Mini-Mental State Examination for Dementia Screening, Elderly Verbal Learning Test, Digit Span Test, Korean-Color Word Stroop Test, Trail Making Test, Verbal Fluency Test, Korean Boston Naming Test-Short form. The association of subjective age and cognitive functioning was analyzed using hierarchical regression analysis. Sex, depression, and chronological age were included as control variables. RESULTS: Hierarchical regression analysis revealed that a younger subjective age was associated with better processing speed, immediate memory, and executive function respectively. Even after controlling for chronological age, depression, and sex, the subjective age was associated with cognitive functioning in old age. CONCLUSION: Beyond chronological age, the subjective experience of age was associated with cognitive aging.
Adult ; Aged ; Aging ; Cognition ; Cognitive Aging ; Dementia ; Depression ; Executive Function ; Humans ; Mass Screening ; Memory, Short-Term ; Stroop Test ; Trail Making Test ; Verbal Learning

Objective: Cognitive impairment has been an area of interest for psychiatrists. Not only do patients with dementia exhibit symptoms associated with cognitive impairment, but those with some mental disorders such as psychotic and mood disorders as well. However, differences in cognitive impairment between these disorders remain unclear. In this study, we used the Korean Mini-Mental State Examination (K-MMSE), a tool that can be easily administered to patients, to compare cognitive impairment profiles among patients with dementia, psychotic disorders, and mood disorders. Methods: We collected demographic and clinical characteristics of 59 patients who were over 50 years old. Cognitive func-tion was assessed using the K-MMSE. Patients were divided into three groups based on International Classification of Diseases 10th revision diagnosis codes: 1) F00-F01 Dementia, 2) F20-F29 Psychotic disorders, and 3) F30-F39 Mood disorders. We compared K-MMSE subscale scores between the three groups using one-way analysis of variance. Results: The three groups did not differ in demographic data. The dementia group showed the lowest scores in orientation to time (standard deviation [SD]=1.45, F=3.233, p<0.05) and place (SD=1.25, F=3.388, p<0.05), as well as registration (SD=1.00, F=4.425, p<0.05) and recall (SD=0.91, F=3.364, p<0.05) of memory compared to the groups with psychotic and mood disorders. The psychotic disorder group showed significant impairment in language (SD=1.34, F=3.348, p<0.05) compared to the other groups. No significant differences were observed in calculation and drawing. Conclusion This study suggests that certain K-MMSE subscale scores could indicate an illness that causes cognitive impairment, especially in dementia, psychotic disorders, and mood disorders. By using K-MMSE profiles, we could provide better in-terventions for patients with cognitive impairment.

Background and Objectives: Oropharyngeal cancers (OPCs) can be staged down to a lower stage with p16 positivity and de-escalated therapy has been the common practice. The aim of this study is to evaluate the survival outcomes based on various clinical factors in advanced OPC patients. Subjects and Method A total of 58 OPC patients in the stage IVA based on the American Joint Committee on Cancer 7th edition were treated with primary surgery or primary chemoradiation therapy from 2010 to 2016. A survival analysis was carried out using the Kaplan- Meier method, log-rank test, and Cox proportional hazards model. Results: The median follow-up was 39.5 months. Thirty-eight and 20 patients received surgery- based and radiation therapy (RT)-based treatments, respectively. Clinical T-stage and treatment method were significant risk factors for 5-year disease-free survival (DFS) rate, and the treatment method was the only significant risk factor for overall-survival (OS) rate. 5-year DFS rate in the surgery-based treatment and RT-based treatment was 76.1% and 36.0% (p=0.001). On multivariate analysis, the surgery-based treatment group was associated with a significantly reduced hazard of death [the hazard ratio (HR) for the radiation-based treatment was 6.565 compared to the surgery-based treatment, p=0.002]. 5-year OS rate in the surgery-based treatment and RT-based treatment was 91.1% and 53.4% (p=0.003), respectively. On the multivariate analysis, the surgery-based treatment group was associated with a significantly reduced hazard of death (the HR for the radiation-based treatment was 7.544 compared to the surgerybased treatment, p=0.012). Conclusion The primary surgery-based treatment for advanced OPC showed a better survival outcome than the primary radiation-based treatment, irrespective of p16 positivity.

PURPOSE: To report two cases of toxic corneal reaction induced by infusion of distilled water into anterior chamber during cataract surgery. CASE SUMMARY: The first case was a 60-year-old female who was inadvertently infused with distilled water for 20 minutes during phacoemulsification in place of balanced salt solution (BSS). The second case was a 70-year-old male who received anterior chamber irrigation with distilled water for approximately 1 minute then and then immediately irrigated with BSS as soon as the mistake was identified. In both cases, topical 1% prednisolone acetate and 5% NaCl solution was immediately administered every hour as well as oral prednisolone at 1 mg/kg for one week after which the dose was slowly tapered. The first case completely returned to normal after 3 months, whereas the second case only requied 1 month to return to pre-surgery conditions. CONCLUSIONS: Patients who were exposed to distilled water within the anterior chamber resulted in corneal endothelial damage and corneal edema proportionate to the amount irrigated. However, The corneal edema gradually healed with treatment and eventually regained translucency without complications, completely.
Aged ; Anterior Chamber ; Cataract ; Corneal Edema ; Female ; Humans ; Hypogonadism ; Male ; Middle Aged ; Mitochondrial Diseases ; Ophthalmoplegia ; Phacoemulsification ; Prednisolone ; Water

We report on a case of cholesterosis bulbi concurrent with secondary glaucoma. A 36-year-old man, with a history of long-standing retinal detachment in his right eye after the irrigation and aspiration of a congenital cataract, presented with a clinical picture of elevated intraocular pressure and ocular pain. Upon slit-lamp examination, we found a ciliary injection and a pseudohypopyon of polychromatic crystals. Gonioscopic examination revealed a large amount of crystals deposited on the trabecular meshwork and mild rubeosis iridis, but the neovascularization of the angle could not be clearly confirmed due to the presence of so many crystals. Pars plana vitrectomy was performed to remove clusters of crystals and bevacizumab was injected intravitreally to treat iris neovascularization. Aqueous aspirate was examined by light microscopy and the typical highly refringent cholesterol crystals were identified. Intraocular pressure returned to a normal level after the bevacizumab injection, although severe cholesterosis was still evident in the anterior chamber. To our knowledge, this would be the first Korean case of cholesterosis bulbi combined with chronic retinal detachment and presumed neovascular glaucoma, which was treated by pars plana vitrectomy and intravitreal bevacizumab injection.
Adult ; Angiogenesis Inhibitors/therapeutic use ; Anterior Chamber/*metabolism ; Antibodies, Monoclonal, Humanized/*therapeutic use ; *Cholesterol ; Eye Diseases/complications/metabolism ; Follow-Up Studies ; Glaucoma/surgery ; Glaucoma, Neovascular/drug therapy/*etiology/surgery ; Humans ; Intraocular Pressure ; Male ; Vitrectomy/*methods