PURPOSE: Keratoconus is a bilateral noninflammatory ecstatic disease of cornea. Clinical manifestations and treatments are well-described , but the exact pathophysiology has many debates. There are many reports on pathologic abnormalities of keratoconus, but few reports on epithelial adhesion complex. The authors investigated the abnormalities in epithelial adhesion complex of keratoconus. METHODS: Using 4 corneas from 4 recipients of penetrating keratoplasty, examination was done with transmission electron microscope (Hitachi-600, Japan) after proper fixation and staining. Central and peripheral portion of each corneal tissues were examined. RESULTS: In two tissues, severe degeneration of basement membrane and Bowman's layer were found. Some degree of abnormalities was found in other tissues, which had minimal change. Some of hemidesmosomes, the most distinct part of adhesion complex, were found only in well-maintained tissue but the distribution was abnormal. CONCLUSIONS: The fact that basal plasma membrane had selectively more degenerations and changes than intercellular plasma membrane implies pathophysiology of keratoconus on adhesion complex, basal plasma membrane, basement membrane and Bowman's layer. Further study on this issue will reveal more information as to its pathophysiology.
Basement Membrane ; Cell Membrane ; Cornea ; Hemidesmosomes ; Keratoconus* ; Keratoplasty, Penetrating

PURPOSE: As computer and Internet are getting widely spread, people who use visual display terminal (VDT) are increasing. Especially as computer and Internet on line games are popular, more people are exposed to VDT than in the past. So we examined to explore the relationship between middle school students' computer using time and dry eye. METHODS: The subjects were 105 middle school male students in the same district. We surveyed them on the time of computer use weekly and ocular discomfort while using computer. We examined anterior segment of the eyes by slit lamp, and checked BUT and Shirmer test. RESULTS: The subjects who frequently use computer showed shorter BUT, dry eye related ocular findings (meniscus floater, corneal erosion.), and symptoms of dry eye. But there was no significant difference in Schirmer test. CONCLUSIONS: Students in middle school age may have symptoms and ocular findings of dry eye owing to increased time of computer use. So proper rest during computer use and adequate education for dry eye are thought to be necessary.
Education ; Humans ; Internet ; Male

Purpose: We present a dehazing algorithm using dark channel prior (DCP) and bright channel prior (BCP) to enhance the quality of retinal images obtained through conventional fundus photography. Methods: A retrospective analysis was conducted on retinal images from patients who visited Gangnam Sacred Heart Hospital between January 2000 and September 2022. These images were captured using a digital fundus camera (KOWA Nonmyd 8S Fundus Camera, KOWA Company, Nagoya, Japan) without pupil dilation. We used two mathematical algorithms: DCP only and DCP and BCP combined. The original, DCP-processed, and DCP & BCP-processed images were compared. Fisher's exact test was used to identify significant quality improvements. Results: The DCP and the newly proposed DCP plus BCP algorithm effectively eliminated haze and enhanced the contrast of cataract images. Notably, DCP demonstrated limited improvements in fundus photographs from patients with small pupils, whereas the proposed DCP plus BCP method effectively revealed previously obscured retinal details and vessels. However, these methods exhibited limited performance in severe cataracts compared to the clear images obtained after surgery. The quality enhancement with the proposed method was significant in photographs of patients with cataracts (p = 0.032) and small pupils (p < 0.01). Conclusions Our algorithm produced clearer images of blood vessels and optic disc structures, while significantly reducing artifacts in fundus images from patients with small pupils or cataracts. The proposed algorithm can provide visually enhanced images, potentially aiding physicians in the diagnosis of retinal diseases in patients with cataracts.

Background: The purpose of this study was to find the weight-related factors related to active attitude towards weight loss in children who are overweight or obese and their parents. Methods: A total of 252 elementary school children who were overweight or obese and their parents were surveyed on weight-related attitudes for one month in May 2003 in Kimhae. The definition of overweight and obesity was based on age and sex-specific Korean children's BMI references established in 1998. Results: Among the total, 64.5% of children and 76.4% of parents thought frequently about losing weight in children. Among the total, 52.8% of children and 47.6% of parents tried losing weight in children more than three times. In children, the factors related to frequent thoughts of losing weight were gender, body mass index (BMI), body dissatisfaction index, and the score of eating attitude (P<0.05). Parents' thought about their children's losing weight and the efforts to persuade their children to lose weight were related to children's frequent thought about losing weight. The children's factors related to trying to lose weight by themselves were age, BMI, and the score of eating attitude. The parent's factors related to children trying to lose weight were body dissatisfaction index of their children by parents, parent's eating attitude score, parent's thought about children's losing weight and making efforts to persuade children to lose weight by parents. The children's eating attitude was related to frequent thoughts about losing weight (odds ratio 1.05, 95% CI 1.03~1.07) and trying to lose weight more than 3 times (odds ratio 1.02, 95% CI 1.003~1.04) after adjusting for other factors. Likewise, parents' effort to persuade their childrento lose weight was related to children's effort to lose weight (odds ratio 2.62, 95% CI 1.34~5.1). Conclusion: Active attitude towards losing weight in overweight or obese children was related to parent's attitude to wards losing weight.
Body Mass Index ; Child* ; Eating ; Feeding Behavior ; Gyeongsangnam-do ; Humans ; Obesity ; Overweight* ; Parents* ; Weight Loss*

BACKGROUND: The purpose of this study was to find the factors associated with becoming obese children during the past 2 years in 6th grade children of elementary school and then to evaluate the high risk groups for childhood obesity. METHODS: The 738 children from May to June, 2001 in 6th grade of 5 elementary schools in Busan were the subjects of this study. The children's height and weight in 4th grade and 6th grade were obtained from school health records. We calculated the body mass index in 4th and 6th grades and classified into 3 weight groups (normal, at risk for obesity, and obese) according to the age and sex-specific BMI established by the Korean Academy of Pediatrics. If children's weight group in 4th grade was changed to heavier weight group in 6th grade, we defined it as increased group. Otherwise, we defined it as non-increased group. The association between the increase in weight group and parental and children's characteristics were analyzed by x2-test, x2-test for the trend, t-test, ANOVA and multiple logistic regression. RESULTS: Among the total, 3.3% of children with normal weight and 16.9% of children at the risk for obesity in 4th grade were transformed to increased group in 6th grade, respectively (P<0.001). Children who had excessive appetite (P<0.001), watched TV greater than or equal to 2 hours per day (P=0.004) or had an obese father (P=0.044) were more likely to become increased group. After adjusting for father's obesity, appetite and TV watching time in children, the odds ratio of transforming to increased group after 2 years in children at risk for obesity or in obese child in 4th grade was 2.5 (95% CI: 1.09~5.55) compared to children with normal weight. Children having excessive appetite were 3.2 times (95% CI: 1.42~7.01) more likely to become the increased group after adjusting for father's obesity, TV watching time and weight in 4th grade. Children watching TV greater than or equal to 2 hours/day was 2.8 times (95% CI: 1.27~6.18) more likely to become increased group after adjusting for father's obesity, appetite and weight in 4th grade. CONCLUSION: The risk of becoming obese was higher in children at risk for obesity or obese children in those with excessive appetite or those who have watched TV> or =2 hours/day for the past two years. These findings suggest promotion of educational plan to prevent childhood obesity.
Appetite ; Body Mass Index ; Busan* ; Child* ; Fathers ; Humans ; Logistic Models ; Obesity ; Odds Ratio ; Parents ; Pediatric Obesity ; Pediatrics ; Risk Factors ; School Health Services

BACKGROUND: There has been a controversy on whether the association between weight and osteoporosis in postmenopausal women was the influence of body fat component or lean body mass. The purpose of this study was to examine the association between body composition and bone mineral density in postmenopausal women. METHODS: The subjects were 41 postmenopausal women older than 50 years old whose bone mineral density (BMD) and body composition were assessed using DEXA and bioelectrical impedence. Aspects of socioeconomic status, postmenopausal period, exercise, smoking and alcohol use were checked. Osteoporosis was defined as any BMD which was 2.5 SD or more below the "young normal" adult. Non-osteoporosis was defined as all BMD above 2.5 SD below the "young normal" adult. Body composition, as continuous variables or ordinal variables, was compared between the two groups. RESULTS: The prevalence of osteoporosis was 58.5% (24/51) in subjects. The women with osteoporosis were older and had lower education level compared to the women with non-osteoporosis. There were significant differences in height (P=0.009), weight (P=0.043), protein mass (P=0.004), mineral mass (P=0.004), and fat-free mass (P=0.005) between the two groups. In contrast, fat mass, % body fat, waist-hip ratio (WHR), and body mass index were not significantly different between the two groups. As the tertile of mineral mass and fat-free mass increased, the prevalence of osteoporosis showed decreased trends. However, there was no significant trend according to fat mass tertiles. When factors of age was adjusted, osteoporosis prevalence decreased 0.7 fold with 1 kg increase in fat-free mass. CONCLUSION: This study suggests that fat-free mass rather than fat mass may be associated with BMD in postmenopausal women.
Adipose Tissue ; Adult ; Body Composition ; Body Mass Index ; Bone Density ; Education ; Female ; Humans ; Middle Aged ; Osteoporosis* ; Postmenopause ; Prevalence ; Smoke ; Smoking ; Social Class ; Waist-Hip Ratio

BACKGROUND: There have been very few studies on the relationship between obesity and dense breast as risk factors of breast cancer in Korean women. Therefore, we evaluated the relationship between BMI and mammographic density in Korean women. METHODS: We recruited 332 women without prior history of breast cancer, breast surgery, radiotherapy, hormone replacement therapy, and family history of breast cancer who underwent screening for mammography and completed a self-administered questionnaire in one general hospital. On the basis of ACR BI-RADS breast composition, four density patterns were classified repeatedly by a radiologist. RESULTS: The mean age, Body Mass Index (BMI), the proportion of postmenopausal women of the study population were 50.4 years, 23.2 kg/m2, and 29.8%, respectively. The proportion of extremely dense breast women was 100% in the underweight group, 77.3% in the normal weight group, 41.4% in class 1 obesity group, and 25% in class 2 obesity group, decreased with increasing BMI. The odds Ratio of BMI to extremely dense breast was 0.82 (95% CI: 0.72~0.93, P value=0.002) after adjustment for age, menache, menopause, and BI-RADS assessment category in logistic regression. CONCLUSION: Our findings showed that the BMI was negatively correlated with mammographic density as well in Korea. Therefore, primary physicians should consider sensitive additional method for breast cancer screening especially in underweight and normal weight Korean women.
Body Mass Index ; Breast ; Breast Neoplasms ; Female ; Hormone Replacement Therapy ; Hospitals, General ; Humans ; Korea ; Mammary Glands, Human ; Mammography ; Mass Screening ; Menopause ; Obesity ; Odds Ratio ; Risk Factors ; Thinness ; Ultrasonography, Mammary ; Surveys and Questionnaires

BACKGROUND: Korean versions of Fat Phobia Scale (short form) (F-scale), Beliefs About Obese Persons Scale (BAOP), and Attitudes Toward Obese Persons Scale (ATOP) which are scales of rating weight bias were assessed to find out the reliability and validity. METHODS: Korean versions of F-scale, BAOP, and ATOP were completed twice by 165 adults (85 males, 80 females; 73 hospital staffs, and 92 teachers). Validity was tested using Spearman correlation and factor analysis. Reliability was analyzed using test-retest analyses (Spearman Rho value). RESULTS: Using factor analyses, F-scale comprised of three factors explaining 55.20% of the total variance, BAOP two factors explaining 53.3% of the total variance, and ATOP six factors explaining 61.61% of the total variance. Spearman correlation between F-scale and ATOP was -0.28 to -0.36 (P < 0.05), suggesting that people who worried about being obese tended to have negative attitudes against obesity. The correlation between F-scale and BAOP was -0.25 to -0.27 (P < 0.05), meaning that people who worried about being obese had a tendency to blame obesity on environmental factors. Cronbach's alpha coefficients were 0.79 to 0.90 for F-scale, 0.34 to 0.38 for BAOP and 0.82 to 0.87 for ATOP. Spearman Rho values were 0.47 for F-scale, 0.50 for BAOP, and 0.47 for ATOP (P < 0.05). The scores of each scale were not related to subjects' sex, BMI, body perception, and weight control efforts, while for ATOP scores older subjects were more likely to have a negative view for obesity (P < 0.05). CONCLUSION: The Korean version of F-scale, ATOP and BAOP could be considered as a tool to evaluate weight-bias however, further study is needed for appropriate application.
Adult ; Bias (Epidemiology) ; Humans ; Male ; Obesity ; Phobic Disorders ; Reproducibility of Results ; Weights and Measures ; Surveys and Questionnaires

Background: The purpose of this study was to evaluate the effectiveness of telephone call reminder on retention rate in obese patients. Methods: A total of 118 patients (85 first-time visitors, 33 re-visitors), who visited an obesity management clinic from May 2003 to May 2004, were divided into the intervention group (n=64) and the comparison group (n=54). The intervention was a telephone call reminder before the appointment date. The retention rate up to 7th visit and body mass index were compared between the two groups. Results: The retention rate was 64.4% at 4th visit (after 66.5+/-29.2 days from the first visit) and 36.4% at 7th visit (after 142.1+/-57.8 days from the first visit). For the first- time visitors, the retention rate at 3rd visit was significantly higher (85.1%) in the intervention group than those in the comparison group (67.6%, P=0.049). Otherwise, there were no significant differences in retention rate and body mass index at each visit between the two groups regardless of the visiting status. However, the body mass index at 4th and 7th visit was significantly lower in the intervention group than in the comparison group among the first-time visitors who completely attended 7 times (P=0.031). Conclusion: We could not find the telephone call reminder to be an effective method to improve retention rate in obesity management clinic. Further intensive approach is needed to promote attendance.
Body Mass Index ; Humans ; Obesity ; Telephone*

PUROPOSE: Surgical critically ill patients require adequate nutrition support and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) guidelines recommend low non-protein calorie:nitrogen ratio (NPC:N ratio, 70~100) for critically ill pateints. In this study, we assess the current use of early parenteral nutrition of surgical critically ill patients and analyze the clinical significance of NPC:N. METHODS: This is a retrospective study of critically ill adult patients who remained in the intensive care unit (ICU) for over 3 days and could not receive enteral nutrition for the first 7 days. Data on parenteral intake of patients were collected from electronic medical records. Association of NPC:N scores with clinical outcome (length of ICU stay, length; of hospital stay, duration of ventilation, and mortality) were analyzed using Pearson correlation and multiple regression. RESULTS: The study included 72 cases, average parenteral calorie intake was 14.6 kcal/kg/day and protein intake was 0.5 g/kg/day. We assessed the NPC:N scores to determine the patients' NPC:N for the first 7 days in ICU close to the A.S.P.E.N guidelines. NPC:N scores showed weak negative correlation with length of hospital stay and duration of mechanical ventilation (r=-0.259, P=0.028; r=-0.495, P=0.001). Multiple regression adjusted with APACHE (Acute Physiology and Chronic Health Evaluation) II score, age, and body mass index showed correlation of higher NPC:N score with decreased length of hospital stay and shorter duration of ventilation (P=0.0001, P=0.035, respectively). However, length of ICU stay and mortality within 60 days showed no significant correlation with NPC:N scores. CONCLUSION: Parenteral calories and protein intakes of critically ill patients in ICU were lower in comparison to A.S.P.E.N. recommendation in this study. Low NPC:N scores might be related to shorter length of hospital stay, duration of mechanical ventilation. Consultation of a nutritional support team could have a positive effect in providing appropriate nutrition support.
Adult ; APACHE ; Body Mass Index ; Critical Illness* ; Electronic Health Records ; Enteral Nutrition ; Humans ; Intensive Care Units ; Length of Stay ; Mortality ; Nitrogen* ; Nutritional Support ; Parenteral Nutrition* ; Physiology ; Protein-Energy Malnutrition ; Respiration, Artificial ; Retrospective Studies ; Ventilation