The primary purpose of this review is to present an overview of relationship between human spontaneous eyeblinking and internal cognitive processes. The second purpose is to address the neural substrates of human eyeblinking based on recent studies focusing on the central dopaminergic system and to explore the significance of spontaneous eyeblinks in neuropsychiatric disorders. We reviewed recent and previous studies on eyeblink patterns under various cognitive tasks. We also reviewed neural substrates of eyeblinking, particularly based on the central dopaminergic system. This paper suggests that spontaneous eyeblinks are highly correlated with various cognitive processes and the activity of central dopaminergic system. Various neuropsychiatric disorders are related to the alteration of the occurrence of eyeblinking. Spontaneous eyeblinking is the unique human behavior that occurs regularly without conscious effort. It is known that the rate of eyeblinking is modulated by internal cognitive processes and dopamine-related neuropsychiatric disorders. Further research is required to how the temporal dynamics of spontaneous eyeblinking is correlated with the disease activity and progression.
Dopamine ; Humans

No abstract available.

Purpose: This study was designed to evaluate the radiological and clinical outcomes of a new surgical technique—customized staple fixation using K-wire—in displaced metacarpal neck or base fractures. Materials and Methods: From November 2016 to May 2017, 13 unstable metacarpal neck and base fractures (10 patients) were treated with II-shaped customized K-wire staples fixation, after performing open reductions through minimal dorsal incisions. The radiological and clinical outcomes were retrospectively evaluated. Results: A mean of 2.6 staples were used for each fracture fixation. Preoperative angulation of 36.3°was reduced to 3.1° postoperatively. A week after surgery, the volar short arm splint was replaced with a dorsal splint to initiate active range of motion exercise, and the splint was subsequently removed after 3 weeks. The radiologic union was achieved at a mean of 5.1 weeks, and total active motion was recovered at a mean of 7.4 weeks. On a mean, K-wire staples were removed at 16.5 weeks after the surgery, and the mean treatment took 18.6 weeks. At the final follow-up (at mean 27.3 weeks), no significant difference was observed for total active motion of the digits and grip strength, when compared to the contralateral hand. Complete union was achieved in all fractures without deformity, or complications such as infection or nerve injury. All patients were satisfied with the cosmetic and functional outcomes. Conclusion K-wire stapling is an effective alternative modality in treating unstable displaced metacarpal neck or base fractures. It requires minimal incision to enable open reduction. In addition, early mobilization is ensured through the rigid fixations. Moreover, it prevents postoperative joint stiffness and reduces the time needed for treatment.

Objective: The purpose of this study was to investigate the effects of depressive symptoms on health-seeking behaviors using the large epidemiological study data of the Korea National Health and Nutrition Examination (KNHANES). Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES), which is a large-scale national survey, were used in this study. The Patient Health Questionnaire-9 (PHQ-9) was used to assess the depressive state of the participants. Specialized self-reported questionnaires that included questions about health-seeking behaviors were also performed. To examine the relationships between depression and health-seeking behaviors, complex sample logistic regression models with control for covariates were used. Results: There was a significant association between decreased health-seeking behaviors and depressive symptoms in adults (odds ratio [OR]: 3.11, 95% confidence interval [CI]: 2.44–3.96). The association was found to be especially strong in males (OR: 2.63, 95% CI: 1.69–4.10) versus in females (OR: 2.49, 95% CI: 1.90–3.27). With regard to age group, younger adults (19–44 years of age) showed the highest OR (OR: 3.07, 95% CI: 2.12–4.45). Conclusion Our findings support the idea that there is a significant association between health-seeking behaviors and depressive symptoms in the Korean population. These results suggest that individuals with decreased health-seeking behaviors could be evaluated for depressive symptoms.

No abstract available.
Thigh

Background: This study aimed to investigate the psychosocial symptoms and experiences of bereaved parents of victims and parents of survivors of the Sewol Ferry accident five years after the accident. Methods: In-depth interviews of 186 bereaved parents of victims or survivors of the Sewol Ferry accident were conducted. We elicited and categorized meaning units relevant to the psychological, cognitive, and physical traits of the participants from these interviews.Differences in responses between bereaved parents and survivors’ parents and between genders were examined using frequency analyses and χ 2 tests. Results: Data were organized under seven headings: observed attitude and impression of participants, difficulties due to mental health problems, difficulties due to physical pain, difficulties in relationships, negative changes following the incident, positive changes following the incident, and help needed. Within these headings, 27 themes, 60 sub-themes, and 80 meaning units were elicited. Conclusion This study explored the psychiatric, physical, and relational problems reported by bereaved parents and those of survivors as well as major changes in their personal and social lives after the Sewol Ferry accident. Differences in responses according to gender were also identified. The results from this study could inform and facilitate the implementation of intervention measures, such as long-term psychological evaluation, to bereaved parents of victims or survivors of disasters.

Objective: In numerous studies that have addressed transcranial direct current stimulation (tDCS) devices, participants visit the hospital regularly and undergo stimulation directed by health professionals. This method has the advantage of being able to deliver accurate stimuli in a controlled environment, but it does not adopt the merits of tDCS portability and applicability. Thus, it may be necessary to investigate how self-administered tDCS treatment at home affects depression-related symptoms. Methods: In this randomized, single-blinded clinical trial, 58 patients with major depressive disorder were assigned to active and sham tDCS stimulation groups, and treatment responses were evaluated biweekly over six weeks. Both active and sham tDCS treatment group were treated with escitalopram. All participants were instructed the protocol and usage of at-home tDCS device, and self-administered tDCS treatment at their home. Results: The beck-depression inventory score decreased significantly as treatment progressed, and the degree of symptom improvement was significantly higher in the active group than in the sham tDCS group. There were no significant differences between the two groups in other indices, including the Hamilton Depression Scale. Conclusion These results suggest that patient-administered tDCS treatment might be effective in improving subjective symptoms of depression.

Objective: Diagnosis and assessment of depression rely on scoring systems based on questionnaires, either self-reported by patients or administered by clinicians, and observation of patient facial expressions during the interviews plays a crucial role in making impressions in clinical settings. Deep learning driven approaches can assist clinicians in the course of diagnosis of depression by recognizing subtle facial expressions and emotions in depression patients. Methods: Seventeen simulated patients who acted as depressed patients participated in this study. A trained psychiatrist structurally interviewed each participant with moderate depression in accordance with a prepared scenario and without depressive features. Interviews were video-recorded, and a facial emotion recognition algorithm was used to classify emotions of each frame. Results: Among seven emotions (anger, disgust, fear, happiness, neutral, sadness, and surprise), sadness was expressed in a higher proportion on average in the depression-simulated group compared to the normal group. Neutral and fear were expressed in higher proportions on average in the normal group compared to the normal group. The overall distribution of emotions between the two groups was significantly different (p ＜ 0.001). Variance in emotion was significantly less in the depression-simulated group (p ＜ 0.05). Conclusion This study suggests a novel and practical approach to understand the emotional expression of depression patients based on deep learning techniques. Further research would allow us to obtain more perspectives on the emotional profiles of clinical patients, potentially providing helpful insights in making diagnosis of depression patients.

The natural course of visual acuity of choroidal neovascularization (CNV) membrane is known to be poor.When fovea is involved, only a subset of patients is eligible for laser photocoagulation or alternative treatment odalities.Radiation therapy has been investigated for applying to such cases, however there have been controversies among reports on the effec-tiveness of radiation therapy.Hence we intended to evaluate the effective-ness of radiation therapy quantitatively.Twenty-one eyes with subfoveal CNV were treated with 4 MV X-ray (total dose of 20 Gy).After the follow-up period of 6months or longer, the visual acuity remained stable or improved from the initial visual acuity in 15 of 21 eyes (71.4%). Based on indocyanine green (ICG)video angiography, the CNVs decreased in their size in 16 of 21 eyes (76.2%)and this difference was statistically significant. These results suggest that radiation can induce regression of subfoveal CNV and maintain central vision in a significant number of patients and we believe that larger, longer study is necessary.
Angiography ; Choroid* ; Choroidal Neovascularization ; Follow-Up Studies ; Humans ; Indocyanine Green ; Light Coagulation ; Membranes ; Visual Acuity

A 63-year-old female complained of transient dysarthria. MRA was conducted to evaluate this symptom, revealing distal internal carotid artery occlusion with collateral vessel development, suggesting Moyamoya disease, which had not been detected in MRA performed 5 years previously. Vascular risk factors and laboratory findings suggested no cardiac or autoimmune diseases. The diameter of stenosis of the middle cerebral artery on high-resolution MRI was 2.11 mm, and genetic evaluation revealed mutation of the gene encoding ring finger protein 213 (RNF213). High-resolution MRI and gene studies are useful for distinguishing between Moyamoya disease and atherosclerosis.
Adult* ; Atherosclerosis ; Autoimmune Diseases ; Carotid Artery, Internal ; Constriction, Pathologic ; Dysarthria ; Female ; Fingers* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Middle Cerebral Artery ; Moyamoya Disease* ; Risk Factors