Purpose: Although the popularity of Descemet membrane endothelial keratoplasty (DMEK) is increased, there is still few clinical studies in Korea. In this study, we aimed to report the initial clinical outcomes of DMEK in patients followed up for more than 6 months. Methods: A total of 96 eyes that underwent DMEK by a single surgeon for Fuchs endothelial corneal dystrophy, pseudophakic bullous keratopathy, or other indications were evaluated for best-corrected visual acuity (BCVA), endothelial cell density (ECD), central corneal thickness (CCT), postoperative complications, and graft survival. Results: The postoperative BCVA significantly increased compared to the preoperative BCVA by 59.4% (1.00 ± 0.77 logarithm of the minimum angle of resolution vs. 0.67 ± 0.76 logarithm of the minimum angle of resolution, p < 0.001). The average preoperative ECD was 754 ± 382 cells/mm2, increasing to 1,333 ± 562 cells/mm2 at 3 months (76.8%, p < 0.001), 1,334 ± 632 cells/mm2 at 6 months (76.9%, p < 0.001), 1,121 ± 474 cells/mm2 at 12 months (48.7%, p = 0.024), and 972 ± 458 cells/mm2 at 24 months postoperatively (28.9%, p = 0.445). Compared to 3 months, the ECD declined by 15.9% at 12 months (p = 0.009) and 27.1% at 24 months postoperatively (p = 0.158). The average CCT was 675 ± 113 μm preoperatively, decreasing to 581 ± 102, 574 ± 101, and 594 ± 94 μm at 6, 12, and 24 months after DMEK, respectively (p < 0.001 between all follow-up time points). Allograft rejection was detected in three (3.1%) and 14 eyes (14.6%) underwent retransplantation at an average of 10.1 ± 8.4 months after DMEK. Conclusions DMEK is promising for maintaining corneal clarity, low postoperative complication rates, and stable graft longevity.

In a case of 46-year-old woman suffering from schizophrenia for over 20 years, she experienced frequent episodes of dyspnea and confirmed as superimposed with myasthenia gravis (MG). Throughout the seven-year follow-up period, after diagnosed as MG, she has been hospitalized 6 times and also diagnosed as colorectal cancer. Authors experienced various conditions associated with untoward effects of medication for myasthenia, schizophrenia, and colorectal cancer. Therefore, authors reported considerations for the pharmacotherapy of schizophrenia with myasthenia gravis.
Colorectal Neoplasms* ; Drug Therapy ; Dyspnea ; Female ; Follow-Up Studies* ; Humans ; Middle Aged ; Myasthenia Gravis* ; Schizophrenia*

OBJECTIVES: This study investigated the relationship between depression, attachment and addiction problems in runaway youths. METHODS: We sent a questionnaire package to 187 runaway youths in 18 adolescent shelters. The questionnaire package collected their sociodemographic data and included the Patient Health Questionnaire-9, Inventory of Parent Attachment (IPA), Korean Internet Addiction Self-Scale (K-Scale), Korean version of Alcohol Use Disorders Identification Test, and Korean version of the Fagerström Test for Nicotine Dependence. RESULTS: The percentage of youth with depression was 28.8% (N=54). In the depression group, there were significantly more problematic alcohol users (53.06%, p=.0199) and significantly lower IPA scores (p=.0064). There was a significant negative correlation between depression and a IPA, and significant positive correlation between depression and the K-Scale. CONCLUSION: These results suggest that runaway youths with depression have more problematic alcohol drinking and attachment problems.
Adolescent* ; Alcohol Drinking ; Child ; Depression* ; Homeless Youth* ; Humans ; Internet ; Parents ; Tobacco Use Disorder

Purpose: Although there is still no consensus on the best animal model for dry eye disease research, a model based on lacrimal gland extraction (LGE) model is widely used. In this study, we aimed to investigate the histopathological changes taking place on the contralateral eye after unilateral LGE to determine whether it is useful as a control. Methods: Seven-week-old male C57BL/6 mice were divided into naive control, environmental chamber model, and LGE groups. Corneal fluorescein staining was scored to quantify the severity of damage. Morphological changes in the cornea, conjunctiva, and lacrimal gland (LG) were determined by hematoxylin and eosin staining and compared to those on naive control animals. Results: Compared to naive subjects, the unilateral LGE model showed enhanced corneal erosion scores and loss of conjunctival goblet cells, not only on the ipsilateral but also on the contralateral side. These changes in the ocular surface became more pronounced in a time-dependent manner. Furthermore, loss of LG acinar cells and leukocyte infiltration were detected in the contralateral LGs of the LGE model. Conclusions Considering the changes observed in the ocular surface and LGs, the contralateral side of the LGE model may not offer proper control conditions for the experimental comparison of the effects of dry eye disease in vivo. There may be regulatory feedback or crosstalk system between both eyes activated in response to LGE.

BACKGROUND: The QT variability index (QTVI)-a non-invasive measure of beat-to-beat QT interval (QTI) fluctuations-is related to myocardial repolarization lability. The QTVI represents the relationship between QTI and the RR interval. Elevated QTVI is associated with an increased risk of malignant ventricular arrhythmias and sudden death. We investigated the influence of general anesthesia and tourniquets on the QTVI. METHODS: We studied fifty patients who received total knee replacement arthroplasty under sevoflurane anesthesia. We measured QTI, corrected QTI (QTc), T-wave peak-to-end interval (TPE), QTVI, and heart rate variability. All variables were calculated at baseline (B), 30 min after general anesthesia (A), 30 min (TQ1) and 60 min (TQ2) after tourniquet inflation, and at tourniquet deflation (TQR). RESULTS: Prolongation of QTI was detected at all times, and QTc was significantly prolonged TQR. TPE was unchanged during general anesthesia. The QTVI was significantly decreased and more negative during anesthesia and tourniquet inflation. After deflation of the tourniquet, the QTVI was restored to preanesthetic values. Low frequency (LF) was significantly decreased during general anesthesia, but high frequency (HF) was somewhat maintained, except at TQ2. The LF/HF ratio was significantly decreased at A and TQ2. CONCLUSIONS: Sevoflurane based general anesthesia induced repolarization stability and, more negativity of the QTVI, in patients undergoing total knee replacement arthroplasty.
Anesthesia ; Anesthesia, General* ; Arrhythmias, Cardiac ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Death, Sudden ; Heart Rate ; Humans ; Inflation, Economic ; Tourniquets

This is an analysis report of the "Korean Academy of Child and Adolescent Psychiatry (KACAP), Vision 2033 Survey". The survey questionnaires were developed by the planning department of KACAP and sent to KACAP members from 2012 to 2013. This survey consisted of six categories : membership, academic activity, journal publication, administrative system, fellowship training program, and future planning. The response rate was 40.5%. In addition to multiple choice questions, responders also described their own ideas and suggestions regarding KACAP. The results of this study can be used as evidence for planning the vision 2033 of KACAP.
Adolescent ; Adolescent Psychiatry* ; Child* ; Education ; Fellowships and Scholarships ; Humans ; Publications ; Surveys and Questionnaires

Psychological resilience in children preventing them from being overwhelmed by traumatic events and nurture their healthy development is universal and powerful. Movies about fairy tales provide children with the notion of the existence of the power and various manifestations. Even though the traumatic event affects the development of the child, with a good supporting system and by providing healthy internal and external factors to reconstruct the event, the traumatized child may accept the event objectively, develop the healthier part of the ego, and even sublimate the traumatic events. As the children participate in movies or plays, several protectors can be devised. The child prepares the role under a "promise" of virtual reality, performs the role recognizing that the traumatic event is not real, and returns to real life as the role or play ends. When these protectors are provided, it is considered that resilience can function properly and the role does not have a negative influence on the development of a child.
Child ; Collodion ; Ego ; Humans ; Mercuric Chloride ; Resilience, Psychological

OBJECTIVES: 'Taegyo,' prenatal education, is steeped into Korean culture. Although there has been a traditional focus on providing education and care for the fetus in Korea, there is a lack of medical evidence for its effectiveness. METHODS: The authors assessed the scientific basis for 'Taegyo' by reviewing the evidences. RESULTS: 'Taegyo' in Korea began with the spread of Buddhist culture from China, and transmitted by word-of-mouth. The first 'Taegyo' book, the Tae-gyo-shin-gi, was published on 1803. Modern prenatal education is very diverse. However, only a few studies on its effect have been conducted. Development of medicine, especially obstetrics, fetology, pediatrics, psychiatry, and etc., has learned that many factors, including bad environmental conditions and maternal stress, influenced against the fetus and mother. As for the paternal side, occupation, smoking, and stress were also revealed to have consequences for the development of the fetus. On the contrary, adequate maternal nutrition, exercise, and music stimulation positively impact the fetal development and healthy birth. CONCLUSION: Traditional contents of 'Taegyo' were proved to have effectiveness from evidence-based medicine and animal experiments. We need further studies to explore the impact of prenatal education for the fetal development and maternal health.
Animal Experimentation ; China ; Education ; Evidence-Based Medicine ; Female ; Fetal Development ; Fetus ; Humans ; Korea ; Maternal Health ; Mothers ; Music ; Obstetrics ; Occupations ; Parturition ; Pediatrics ; Pregnant Women ; Prenatal Care ; Prenatal Education* ; Smoke ; Smoking ; Stress, Psychological

No abstract available.
Humans ; Shoulder* ; Stents* ; Thrombosis*

OBJECTIVES: The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic. METHODS: Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators. RESULTS: The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak. CONCLUSIONS Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.