A 46-year-old female patient was admitted to the intensive care unit (ICU) after liver transplantation. About an hour later after the ICU admission, she had no pupillary light reflex. Both pupils were also fixed at 5 mm. Patients who undergo liver transplantation are susceptible to neurologic disorders including hepatic encephalopathy, thromboembolism and intracranial hemorrhage. Abnormal pupillary light reflex usually indicates a serious neurologic emergency in these patients; however, benign neurologic disorders such as peripheral autonomic neuropathy or Holmes-Adie syndrome should also be considered. We experienced a case of fixed pupillary light reflex after liver transplantation diagnosed as peripheral autonomic neuropathy.
Adie Syndrome ; Emergencies ; Female ; Hepatic Encephalopathy ; Humans ; Intensive Care Units ; Intracranial Hemorrhages ; Liver Transplantation* ; Liver* ; Middle Aged ; Nervous System Diseases ; Peripheral Nervous System Diseases* ; Pupil ; Reflex* ; Reflex, Pupillary ; Thromboembolism

OBJECTIVES: The purpose of this study is to 1) conduct a discrimination analysis of schizophrenia and bipolar affective disorder using MMPI profile through artificial neural network analysis and logistic regression analysis, 2) to make a comparison between advantages and disadvantages of the two methods, and 3) to demonstrate the usefulness of artificial neural network analysis of psychiatric data. PROCEDURE: The MMPI profiles for 181 schizophrenia and bipolar affective disorder patients were selected. Of these profiles, 50 were randomly placed in the learning group and the remaining 131 were placed in the validation group. The artificial neural network was trained using the profiles of the learning group and the 131 profiles of the validation group were analyzed. A logistic regression analysis was then conducted in a similar manner. The results of the two analyses were compared and contrasted using sensitivity, specificity, ROC curves, and kappa index. RESULTS: Logistic regression analysis and artificial neural network analysis both exhibited satisfactory discriminating ability at Kappa index of greater than 0.4. The comparison of the two methods revealed artificial neural network analysis is superior to logistic regression analysis in its discriminating capacity, displaying higher values of Kappa index, specificity, and AUC(Area Under the Curve) of ROC curve than those of logistic regression analysis. CONCLUSION: Artificial neural network analysis is a new tool whose frequency of use has been increasing for its superiority in nonlinear applications. However, it does possess insufficiencies such as difficulties in understanding the relationship between dependent and independent variables. Nevertheless, when used in conjunction with other analysis tools which supplement it, such as the logistic regression analysis, it may serve as a powerful tool for psychiatric data analysis.
Discrimination (Psychology) ; Humans ; Learning ; Logistic Models* ; MMPI* ; Mood Disorders ; ROC Curve ; Schizophrenia ; Sensitivity and Specificity ; Statistics as Topic

The final degrees of education for the third and fourth authors were mutually misplaced.

Objectives: The purpose of this study was to investigate the association between the Basic Old-Age Pension (BOP), which is a noncontributory pension, and depression in BOP beneficiaries in Korea. Methods: We used the second and third waves (2007-2008) of the Korea Welfare Panel Study to identify the effect of the BOP on mental health in the year of its introduction. The Center for Epidemiological Studies-Depression Scale, applied in a Korean context, was used to evaluate mental health. To analyze the effect of the BOP, a difference-in-difference approach was used in analyses of all subjects and subgroups. Results: For this study population of 760 adults, the BOP did not have a statistically significant relationship with depression in its beneficiaries. After controlling for type of household, the BOP was still not associated with lower reporting of depression, either in singlebeneficiary or double-beneficiary households, in the year of the benefit. Conclusions The BOP policy had no significant relationship with the level of depression among recipients. However, this should not be interpreted as implying that income subsidy programs for older adults, such as the BOP, do not affect mental health, considering the importance of economic hardship in this population and the program’s socioeconomic effects.

Objectives: This study investigated the prevalence of ophthalmic diseases in Quang Tri and Thai Nguyen, Vietnam, utilizing a smartphone-based fundus imaging (SBFI) system. Methods: This cross-sectional study included nearly 10,000 patients who visited community health centers between July and August 2019. All participants underwent visual acuity testing and fundus imaging. We collected demographic data and medical histories, and fundus images were captured using the EYELIKE system. Data were compiled on an online platform, allowing clinicians from other regions to make diagnoses. Results: The study revealed significant variations in visual acuity and the prevalence of ophthalmic diseases between the two regions. Quang Tri had a higher proportion of individuals with good eyesight compared to Thai Nguyen. In Quang Tri, nearly 50% of the population had media haze, while in Thai Nguyen, about one-third of the population was affected. The prevalence of glaucomatous optic nerve and age-related macular degeneration was approximately 1% higher in Quang Tri than in Thai Nguyen. These findings provide valuable insights into the eye health status of these regions, indicating that eye health in Quang Tri was poorer than in Thai Nguyen. Conclusions The prevalence rates of ophthalmic conditions in this study were within the expected ranges compared to those in other Asian countries, though they were somewhat low. The SBFI method, being simpler and more efficient than the Rapid Assessment of Avoidable Blindness, offers a promising approach for measuring and estimating the prevalence of ophthalmic diseases.

Purpose: The psychiatric survivors movement, which represents people with mental disorders (PWMD), recognizes the autonomy of PWMD activists and emphasizes peer support and advocacy. However, in South Korea, where this movement is still in its early stages, the activities associated with it are not clearly defined. This paper aims to explore the role identities of PWMD activists and examine their significance. Methods: We conducted one or two in-depth interviews with 12 PWMD activists to gather data. The interviews were designed to uncover the participants’ perspectives on their roles as PWMD activists and their understanding of these roles. Thematic analysis was used to identify common themes. Results: The overall theme that emerged from the role identities of PWMD activists was “one who publicly advocates for the rights of the group while leading colleagues towards personal growth and societal change.” Within this overarching theme, three sub-themes were identified: intrapersonal, interpersonal, and socio-political aspects. In total, we identified 10 sub-themes. Conclusion Our findings can inform the development of various activities that support the recovery of PWMD, enabling them to assist their peers and advocate for their future interests, while also ensuring that their roles are reflected in policies.

PURPOSE: The purpose of this study was to develop a relapse prevention program (RPP) and examine the effects of the RPP on insight, empowerment, and treatment adherence in patients with schizophrenia. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 54 inpatients who had a diagnosis of schizophrenia (experimental group: 26, control group: 28). The study was carried out from February 7, 2012 to February 6, 2013. Over a 10-day period prior to discharge each participant in the experimental group received three one-hour sessions of RPP a one-to-one patient-nurse interaction. Data were collected using Assess Unawareness of Mental Disorder (SUMD), Empowerment Scale, and Insight and Treatment Attitude Questionnaire (ITAQ) and analyzed using PASW 18.0 with chi-square test, independent t-test, Mann-Whitney U test, and ANCOVA. RESULTS: The experimental group had a significant increase in insight and treatment adherence compared to the control group. However, there was no significant difference in empowerment between the two groups. CONCLUSION: Findings indicate that the RPP for patients with schizophrenia was effective in improving insight and treatment adherence. A longitudinal study is needed to confirm the persistence of these effects of RPP in patients with schizophrenia.
Diagnosis ; Humans ; Inpatients ; Longitudinal Studies ; Mental Disorders ; Power (Psychology)* ; Recurrence* ; Schizophrenia* ; Secondary Prevention*

Transcranial cranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that consists of applying a weak current over the scalp to modulate cortical excitability by facilitating or inhibiting ongoing neuronal processes. tDCS is attracting much attention among researchers and clinicians because it has a low risk and low cost, and it is simple to operate, being portable. In this review, the authors provide a summary of developmental history, technical aspects and mechanism of action of tDCS and review the current literature regarding the use of tDCS in psychiatry. Depression was the most extensively researched condition, followed by schizophrenia, substance use disorders, and obsessive-compulsive disorder. Other topics explored were child and adolescent psychiatry. This review suggested that tDCS interventions comprising multiple sessions can alleviate symptoms of several major psychiatric disorders, both acutely and in the long-term and are well tolerated and safe for patients including child and adolescent. Nevertheless, the number of publications regarding tDCS is low and randomized controlled trials are very few. Evidence from large-scale, multi-center randomized controlled trials is required to transition this technique from the laboratory to the clinic. In addition, tDCS parameters such as electrode size, dosage, and location of electrode should be investigated.
Adolescent ; Adolescent Psychiatry ; Brain ; Child ; Depression ; Electrodes ; Humans ; Neurons ; Obsessive-Compulsive Disorder ; Scalp ; Schizophrenia ; Substance-Related Disorders ; Transcranial Direct Current Stimulation*

Research using experimental animals has substantially contributed to advances in science and medicine. Animal experiments are nearly essential for biomedical research and development efforts. Because many animals are sacrificed, researchers should consider the welfare of experimental animals and related ethical issues, along with the successful results of their experiments. This review introduces the criteria that should be considered in terms of experimental animal ethics, based on the principles of the 3 R’s: replacement, representing careful consideration of the need for animal experiments; reduction, representing the use of the minimal number of animals to obtain meaningful experimental results; and refinement, representing continuous effects to find alternative methods to reduce pain and distress in experimental animals. Based on these principles, the following points should be considered when planning experiments: the necessity of animal experiments; alternatives to animal experiments; the relevance of the species and numbers of experimental animals; appropriate assessment and management of pain; the proper usage of sedatives, painkillers, and anesthesia; and valid timing for humane endpoints and euthanasia. These criteria are beneficial for both experimental animals and researchers because careful handling to ensure experimental animal welfare guarantees that scientific research will yield convincing, repeatable, and accurate results.