Objectives: ：The purpose of this study was to investigate individual- and community-level factors on suicidal ideation and suicide attempt among Korean adults. Methods: ：This study was conducted on 225,965 adults collected through data from the 2021 Community Health Survey and the Korean Statistical Information Service (KOSIS). The general characteristics, suicidal behavior (e.g., suicidal ideation, and suicide attempts), and community-level characteristics of the study subjects were analyzed using frequency (%) and mean (standard deviation). The effects on individual- and community-level factors on suicidal ideation and suicide attempts was analyzed using multilevel logistic regression models. Results: ：The community-level factor associated with suicidal ideation was unmet health care (Odds Ratio [OR]=1.053, 95% CI=1.035-1.071), and the community-level factor associated with suicide attempt was the aging rate (OR=1.015, 95% CI=1.001-1.030). Regarding health-related variables, the individual-level factors associated with suicidal ideation were stress status (OR=9.388, 95% CI=8.629-10.213), depressive experience in the past year (OR=6.737, 95% CI=6.454-7.032), and the predominantly individual-level factors associated with suicide attempt were also stress status (OR=5.213, 95% CI=3.699-7.347), and depressive experience in the last one year (OR=13.433, 95% CI: 11.247-16.044). Conclusions ：We confirmed individual-level and community-level factors influencing suicidal ideation and suicide attempt. Through these findings, we need to establish suicide prevention policies, considering managing in-dividual-level factors such as stress and depression as well as community-level factors such as unmet health care.

Objectives: ：The purpose of this study was to investigate individual- and community-level factors on suicidal ideation and suicide attempt among Korean adults. Methods: ：This study was conducted on 225,965 adults collected through data from the 2021 Community Health Survey and the Korean Statistical Information Service (KOSIS). The general characteristics, suicidal behavior (e.g., suicidal ideation, and suicide attempts), and community-level characteristics of the study subjects were analyzed using frequency (%) and mean (standard deviation). The effects on individual- and community-level factors on suicidal ideation and suicide attempts was analyzed using multilevel logistic regression models. Results: ：The community-level factor associated with suicidal ideation was unmet health care (Odds Ratio [OR]=1.053, 95% CI=1.035-1.071), and the community-level factor associated with suicide attempt was the aging rate (OR=1.015, 95% CI=1.001-1.030). Regarding health-related variables, the individual-level factors associated with suicidal ideation were stress status (OR=9.388, 95% CI=8.629-10.213), depressive experience in the past year (OR=6.737, 95% CI=6.454-7.032), and the predominantly individual-level factors associated with suicide attempt were also stress status (OR=5.213, 95% CI=3.699-7.347), and depressive experience in the last one year (OR=13.433, 95% CI: 11.247-16.044). Conclusions ：We confirmed individual-level and community-level factors influencing suicidal ideation and suicide attempt. Through these findings, we need to establish suicide prevention policies, considering managing in-dividual-level factors such as stress and depression as well as community-level factors such as unmet health care.

Objectives: ：The purpose of this study was to investigate individual- and community-level factors on suicidal ideation and suicide attempt among Korean adults. Methods: ：This study was conducted on 225,965 adults collected through data from the 2021 Community Health Survey and the Korean Statistical Information Service (KOSIS). The general characteristics, suicidal behavior (e.g., suicidal ideation, and suicide attempts), and community-level characteristics of the study subjects were analyzed using frequency (%) and mean (standard deviation). The effects on individual- and community-level factors on suicidal ideation and suicide attempts was analyzed using multilevel logistic regression models. Results: ：The community-level factor associated with suicidal ideation was unmet health care (Odds Ratio [OR]=1.053, 95% CI=1.035-1.071), and the community-level factor associated with suicide attempt was the aging rate (OR=1.015, 95% CI=1.001-1.030). Regarding health-related variables, the individual-level factors associated with suicidal ideation were stress status (OR=9.388, 95% CI=8.629-10.213), depressive experience in the past year (OR=6.737, 95% CI=6.454-7.032), and the predominantly individual-level factors associated with suicide attempt were also stress status (OR=5.213, 95% CI=3.699-7.347), and depressive experience in the last one year (OR=13.433, 95% CI: 11.247-16.044). Conclusions ：We confirmed individual-level and community-level factors influencing suicidal ideation and suicide attempt. Through these findings, we need to establish suicide prevention policies, considering managing in-dividual-level factors such as stress and depression as well as community-level factors such as unmet health care.

Objectives: ：The purpose of this study was to investigate individual- and community-level factors on suicidal ideation and suicide attempt among Korean adults. Methods: ：This study was conducted on 225,965 adults collected through data from the 2021 Community Health Survey and the Korean Statistical Information Service (KOSIS). The general characteristics, suicidal behavior (e.g., suicidal ideation, and suicide attempts), and community-level characteristics of the study subjects were analyzed using frequency (%) and mean (standard deviation). The effects on individual- and community-level factors on suicidal ideation and suicide attempts was analyzed using multilevel logistic regression models. Results: ：The community-level factor associated with suicidal ideation was unmet health care (Odds Ratio [OR]=1.053, 95% CI=1.035-1.071), and the community-level factor associated with suicide attempt was the aging rate (OR=1.015, 95% CI=1.001-1.030). Regarding health-related variables, the individual-level factors associated with suicidal ideation were stress status (OR=9.388, 95% CI=8.629-10.213), depressive experience in the past year (OR=6.737, 95% CI=6.454-7.032), and the predominantly individual-level factors associated with suicide attempt were also stress status (OR=5.213, 95% CI=3.699-7.347), and depressive experience in the last one year (OR=13.433, 95% CI: 11.247-16.044). Conclusions ：We confirmed individual-level and community-level factors influencing suicidal ideation and suicide attempt. Through these findings, we need to establish suicide prevention policies, considering managing in-dividual-level factors such as stress and depression as well as community-level factors such as unmet health care.

Objectives: ：The purpose of this study was to investigate individual- and community-level factors on suicidal ideation and suicide attempt among Korean adults. Methods: ：This study was conducted on 225,965 adults collected through data from the 2021 Community Health Survey and the Korean Statistical Information Service (KOSIS). The general characteristics, suicidal behavior (e.g., suicidal ideation, and suicide attempts), and community-level characteristics of the study subjects were analyzed using frequency (%) and mean (standard deviation). The effects on individual- and community-level factors on suicidal ideation and suicide attempts was analyzed using multilevel logistic regression models. Results: ：The community-level factor associated with suicidal ideation was unmet health care (Odds Ratio [OR]=1.053, 95% CI=1.035-1.071), and the community-level factor associated with suicide attempt was the aging rate (OR=1.015, 95% CI=1.001-1.030). Regarding health-related variables, the individual-level factors associated with suicidal ideation were stress status (OR=9.388, 95% CI=8.629-10.213), depressive experience in the past year (OR=6.737, 95% CI=6.454-7.032), and the predominantly individual-level factors associated with suicide attempt were also stress status (OR=5.213, 95% CI=3.699-7.347), and depressive experience in the last one year (OR=13.433, 95% CI: 11.247-16.044). Conclusions ：We confirmed individual-level and community-level factors influencing suicidal ideation and suicide attempt. Through these findings, we need to establish suicide prevention policies, considering managing in-dividual-level factors such as stress and depression as well as community-level factors such as unmet health care.

PURPOSE: This study was to investigate the effect of instability on the activation of lower limb muscles during lunge exercise. METHODS: The study subjects were healthy twenties and were selected to have no orthopedic or neurological diseases. 1) Flat lunge exercise (Lunge 1, 2) Lunge exercise on TOGU (Lunge 2, 3) Holding the olympic bar and moving the lunge on TOGU (Lunge 3, 4) Holding the Surge and moving the lunge on TOGU (Lunge 4). Through the above four actions, we can see how the top-down instability influences the lower limb unlike the Bottom-up instability. EMG attachment sites were gluteus medius, vastus medialis, gastrocnemius, tibialis anterior. RESULTS: These result suggest that exercise using Lunge 4 activity was the highest in muscle activity compared to other exercises, but vastus medialis showed the highest muscle activity in Lunge 2 exercise(p<0.05). CONCLUSION This study showed the muscular activity of the lower extremities according to the lunge exercise using the instability tools.

Purpose: To compare the results of lacrimal syringing performed in clinical practice and under general anesthesia, and the clinical efficacy of lacrimal syringing under general anesthesia before endoscopic dacryocystorhinostomy and dacryoscintigraphy. Methods: The study included 148 eyes of 82 patients who underwent endoscopic dacryocystorhinostomy and silicone tube intubation from August 2018 to April 2019. The patients were examined with lacrimal syringing in clinical practice and re‐examined under general anesthesia. Based on the change in lacrimal syringing, the patients were assigned to inconsistent and consistent groups. The inconsistent group was subclassified into complete (‘regurgitation’ of lacrimal syringing changes to a ‘passage’ pattern) and partial improvement groups (the degree of regurgitation improves under general anesthesia). Results: Twenty (13.5%) eyes showed inconsistent results of lacrimal syringing performed in clinical practice and under general anesthesia; all showed improved passage under general anesthesia. The surgical results did not differ significantly (p = 0.336) between the consistent and inconsistent groups, but did between the complete and partial improvement groups (p < 0.01). Conclusions Lacrimal syringing under general anesthesia may enable an accurate preoperative diagnosis of the degree of obstruction. The combined results of dacryoscintigraphy and lacrimal syringing performed in clinical practice and under general anesthesia allow surgeons to evaluate the lacrimal drainage anatomy precisely and may be useful for predicting the functional success of endoscopic dacryocystorhinostomy.

PURPOSE: Breast cancer has a high prevalence in Korea. To achieve personalized therapy for breast cancer, long-term follow-up specimens are needed for next-generation sequencing (NGS) and multigene analysis. Formalin-fixed paraffin-embedded (FFPE) samples are easier to store than fresh frozen (FF) samples. The objective of this study was to optimize RNA extraction from FFPE blocks for NGS. METHODS: RNA quality from FF and FFPE tissues (n=5), expected RNA amount per unit area, the relationship between archiving time and quantity/quality of FFPE-extracted RNA (n=14), differences in quantitative real-time polymerase chain reaction (qRT-PCR) and NGS results, and comparisons of both techniques with tissue processing at different institutions (n=96) were determined in this study. RESULTS: The quality of RNA did not show any statistically significant difference between paired FF and FFPE specimens (p=0.49). Analysis of tumor cellularity gave an expected RNA amount of 33.25 ng/mm2. Archiving time affected RNA quality, showing a negative correlation with RNA integrity number and a positive correlation with threshold cycle. However, RNA from samples as old as 10 years showed a 100% success rate in qRT-PCR using short primers, showing that the effect of archiving time can be overcome by proper experiment design. NGS showed a higher success rate than qRT-PCR. Specimens from institution B (n=46), which were often stored in a refrigerator for more than 6 hours and fixed without slicing, showed lower success rates and worse results than specimens from the other institutes. CONCLUSION: Archived FFPE tissues can be used to extract RNA for NGS if they are properly processed before fixation. The expected amount of RNA per unit size calculated in this study will be useful for other researchers.
Academies and Institutes ; Breast Neoplasms ; Estrogens ; Follow-Up Studies ; Humans ; Korea ; Prevalence ; Real-Time Polymerase Chain Reaction ; RNA* ; Sequence Analysis

Neurological deficits after brain surgery are not uncommon, and correct and prompt differential diagnosis is essential to initiate appropriate treatment. We describe a patient suffering from loss of consciousness due to hyperammonemia, following valproic acid treatment after surgery for an unruptured cerebral aneurysm. A 57-year-old female patient underwent successful aneurysmal neck clipping to correct an unruptured aneurysm. Her postoperative course was good, and she received anti-epileptic therapy (valproic acid) and a soft diet. Within a few days the patient experienced mental deterioration. Her serum valproic acid reached toxic levels (149.40 mg/L), and serum ammonia was fifteen times the upper normal limit (553 mmol/L; normal range, 9-33 mmol/L). After discontinuation of valproic acid and with conservative treatment, the patient recovered without any complications. Valproate-induced hyperammonemic encephalopathy is an unusual but serious neurosurgical complication, and should not be disregarded as a possible cause of neurological deficits after neurovascular surgery. Early diagnosis is crucial, as discontinuation of valproic acid therapy can prevent serious complications, including death.
Ammonia ; Aneurysm* ; Brain ; Diagnosis, Differential ; Diet ; Early Diagnosis ; Female ; Humans ; Hyperammonemia ; Intracranial Aneurysm ; Middle Aged ; Neck ; Reference Values ; Unconsciousness ; Valproic Acid

Although it is well known that sleep disturbances can be developed in complete blindness, normally entrained circadian rhythm was observed in the majority of patients with partial blindness. Here, we describe a case with circadian rhythm sleep-wake disorder in partial loss of light perception. A 58-year-old man presented with difficulty in sleep initiation and excessive daytime sleepiness after retinal surgery. The electroretinography revealed partial impairment of light perception in the right side and preserved light perception in the left side. He was diagnosed as circadian rhythm sleep-wake disorder due to impaired light perception. While taking 2 mg of melatonin regularly at 9 every night, his sleep cycle and difficulty in sleep initiation were gradually improved and became fully normalized after 2 weeks. Circadian rhythm sleep-wake disorder could be developed even in partial blindness. Melatonin supplements could effectively improve the circadian rhythm sleep-wake disorder in partial blindness, like as in complete blindness.
Blindness ; Circadian Rhythm ; Electroretinography ; Humans ; Melatonin ; Middle Aged ; Retinaldehyde