Purpose: To report a case of optic neuritis associated with myelin oligodendrocyte glycoprotein (MOG) antibodies, treated with intravenous methylprednisolone pulse therapy.Case summary: A 40-year-old male patient with no underlying disease presented to clinic with sudden onset of bilateral blurry vision that began three days ago. He experienced severe headache and had history of bilateral refractive surgery. Best-corrected visual acuity measured right 0.06 and left 0.04. Relative afferent pupillary defect test was unremarkable, while Ishihara color vision test revealed inability to read any numbers in both eyes, except control plates. Although there were no limitations in extraocular movements, the patient reported pain in both eyes for all gaze movements. Widefield photograph and retinal nerve fiber layer image confirmed swelling of optic nerve head in both eyes. He was treated with high-dose intravenous methylprednisolone (1 g/day for 3 days). Magnetic resonance imaging demonstrated enhancement of the optic nerve sheaths in both eyes, and serum testing indicated positivity for MOG IgG antibodies. Three weeks later, visual acuity in both eyes improved to 1.0, and the color vision test showed correct identification of all 17 plates. Optic nerve head swelling in both eyes had resolved. However, optic neuritis recurred at 4, 6 weeks, and 3 months after the initial treatment, with each episode managed by high-dose intravenous methylprednisolone. Conclusions This case shows early diagnosis and treatment of MOG antibody-associated optic neuritis can lead to improved visual outcomes. Appropriate serum testing for the diagnosis may be effective in patients with MOG antibody-associated optic neuritis.

Objective: The Montreal Cognitive Assessment (MoCA) is recommended for general cognitive evaluation in Parkinson’s disease (PD) patients. However, age- and education-adjusted cutoffs specifically for PD have not been developed or systematically validated across PD cohorts with diverse education levels. Methods: In this retrospective analysis, we utilized data from 1,293 Korean patients with PD whose cognitive diagnoses were determined through comprehensive neuropsychological assessments. Age- and education-adjusted cutoffs were formulated based on 1,202 patients with PD. To identify the optimal machine learning model, clinical parameters and MoCA domain scores from 416 patients with PD were used. Comparative analyses between machine learning methods and different cutoff criteria were conducted on an additional 91 consecutive patients with PD. Results: The cutoffs for cognitive impairment decrease with increasing age within the same education level. Similarly, lower education levels within the same age group correspond to lower cutoffs. For individuals aged 60–80 years, cutoffs were set as follows: 25 or 24 years for those with more than 12 years of education, 23 or 22 years for 10–12 years, and 21 or 20 years for 7–9 years. Comparisons between age- and education-adjusted cutoffs and the machine learning method showed comparable accuracies. The cutoff method resulted in a higher sensitivity (0.8627), whereas machine learning yielded higher specificity (0.8250). Conclusion Both the age- and education-adjusted cutoff methods and machine learning methods demonstrated high effectiveness in detecting cognitive impairment in PD patients. This study highlights the necessity of tailored cutoffs and suggests the potential of machine learning to improve cognitive assessment in PD patients.

Purpose: To report the long-term clinical outcomes of non-surgical treatment involving prosthetic eye wear in patients diagnosed with congenital microphthalmos. Methods: A retrospective review of the medical records of 20 patients was conducted. In total, 21 eyes were diagnosed with congenital microphthalmos between May 2008 and December 2022 at Seoul St. Mary’s Hospital in Korea. Results: This study included 20 patients (12 males and 8 females) with an average age of 4 months at diagnosis. The observed ophthalmic anomalies included two cases of congenital cataract, one of posterior embryotoxon, one of corneo-iris strand, four of iris coloboma, five of central corneal opacity, one of Peter's anomaly, and one of retrobulbar cyst. Accompanying systemic abnormalities were noted, such as lateral ventricle atrophy, corpus callosum atrophy, patent ductus arteriosus, atrial septal defect, and developmental language disorder. Genetic anomalies included anti SS-A/Ro antibody positivity, a 1:100 titer of anti-nuclear antibody, and a PAX6 mutation identified through next-generation sequencing. No specific family histories or pregnancy-related factors were noted. The average follow-up duration was 5.94 years (range: 1 month to 18 years), the average corneal diameter was 4.6 mm, the average axial length was 17.44 mm, the average age for first artificial eye trial was 5.96 years (range: 7 months to 19 years), and the average interval for artificial eye replacement was 22 months (range: 4 months to 5 years and 8 months). Conclusions Twenty patients with congenital microphthalmos underwent gradual expansion of their prosthetic eyes by regular replacement and size increase without severe complications. This approach led to aesthetically and emotionally positive outcomes for the patients.

Purpose: In the present study, we determined the prevalence of obstructive meibomian gland dysfunction (MGD), hyposecretory MGD, grossly normal MG, and hypersecretory MGD in patients with dry eye syndrome using lipid layer thickness (LLT) and MG dropout. Methods: Eighty-eight patients with dry eye syndrome were included in the study. Patients were categorized into four groups according to the LLT and weighted total meiboscore. The proportion of patients in each group was calculated. The age, sex, Ocular Surface Disease Index, LLT, Schirmer, tear film breakup time, cornea stain, weighted total meiboscore, expressibility, and quality of meibum were compared between the four groups. Results: Fifteen eyes (17.0%) had obstructive MGD, two eyes (2.3%) had hyposecretory MGD, 40 eyes (45.5%) had grossly normal MG, and 17 eyes (19.3%) had hypersecretory MGD. The obstructive MGD group was younger than the grossly normal MG group. In obstructive MGD, the ratio of men to women was higher than that of the other groups. However, Ocular Surface Disease Index, Schirmer, tear film breakup time, and corneal stain did not show statistically significant differences between the four groups. The meibum expressibility of the hyposecretoy MGD group was worse than those of the other groups. The meibum expressibility of the hyposecretoy MGD group was poor than those of the obstructive and hypersecretory MGD group. Conclusions This categorization was expected to help determine the best treatment method for dry eye syndrome, according to the MG status.

Objectives: The purpose of this study is to analyze the prevalence and factors of depression among the elderly population, a significant issue in Korea’s aging society. We aim to provide basic indicators for improving mental health and quality of life. Methods: From February to December 2021, a study was conducted on a population of 19,158 elderly individuals aged 65 and above residing in Gyeongsangbuk-do province. The severity of depression was evaluated using the Korean version of the Patient Health Questionnaire (PHQ)-9. In addition, demographic information was collected to analyze factors that may influence depression. Results: In the PHQ-9 screening, the average score was 3.65. The results showed that 13,705 individuals (71.5%) were in the normal group with scores ranging from 0 to 4, 3,683 individuals (19.2%) were in the mild group with scores ranging from 5 to 9, 1,575 individuals (8.2%) were in the moderate group with scores ranging from 10 to 19, and 195 individuals (1.0%) were in the severe group with scores of 20 or higher. It was found that place of residence, education level, type of housing, top two difficulties in daily life, subjective economic status, desired services, subjective mental health, past and current history of mental health treatment, and medication for physical illness had statistically significant effects on depression. Conclusions Various factors were found to have a significant impact on depression among the elderly population in Gyeongsangbuk-do. Proactive prevention and treatment tailored to the population characteristics of the region may be necessary.

Objectives: This study identifies the socioeconomic characteristics and attitudes toward suicide (ATTS) of gatekeepers participating in a suicide prevention project in Gyeongsangbuk-do. Through this study we hope to increase the understanding required to prevent suicide in the community. Methods: We conducted a survey from October 11 to November 4, 2022, with 1,284 individuals from private organizations who participated in the suicide prevention project between September 23 and November 30, 2022. The survey established demographic characteristics, experience in participating in suicide prevention projects, awareness and need for suicide prevention and mental health services, and ATTS. The study conducted cross-analysis and chi-square tests to identify differences in responses according to demographics. An independent sample t-test, one-way analysis of variance, and Scheffe’s post hoc test were performed to analyze the comparisons between each measurement factor. SPSS 21.0 was used to process data and the level of statistical significance was set to p<0.05. Results: The gatekeepers’ ATTS were moderate, with an average of 3.11 out of 5. Specifically, preventability obtained the highest score (4.07), followed by preparedness to prevent (3.96), incomprehensibility (3.74), and noncommunication (3.34). Conversely, resignation obtained the lowest score (2.05), followed by tabooing (2.32) and relation-caused (2.51). The scores for preventability and preparedness to prevent increased with sustained participation in the suicide prevention program, while those for suicidal process decreased. Conclusions Gatekeepers’ ATTS may improve as a result of participation in the suicide prevention project, with better results with continued participation. Thus, actively recruiting more gatekeepers and keeping them engaged in the program may help prevent suicide.

Objectives: ：The purpose of this study was to identify suicide risk factors among elderly residents in Gyeongsangbuk-do and to reveal the relationships between them. In addition, the differences in suicide risk factors were analyzed between the cognitively impaired group and the cognitively normal group. Methods: ：We investigated 20,127 elderly over 65 years of age, from January 2019 to December 2019. Participants were asked to complete a questionnaire survey. Cognitive function, depression, anxiety, sleep disturbance, and suicidal ideation data were assessed using a Korean version of the Mini-Mental Status Examination for Dementia Screening (MMSE-DS), Short Geriatric Depression Scale for Korean version (S-GDS), Geriatric Anxiety Inventory (GAI), Athens Insomnia Scale (AIS), and Scale for Suicidal Ideation (SSI). Data were analyzed using the chi-squared test and logistic regression analysis to examine suicide risk factors and the relationships between them. Furthermore, differences in suicide risk factors according to cognitive function were examined. Results: ：Age, cognitive function, depression, anxiety, and sleep disturbance were identified as suicide risk factors among elderly residents in Gyeongsangbuk-do. Depression was the factor that increased risk of suicide the most, followed by anxiety, impaired cognitive function, sleep disturbance, and 65-74 years of age. In addition, depression increased risk of suicide by 1.86 times in the cognitively impaired group. Conclusions ：Among elderly residents in Gyeongsangbuk-do, depression was the factor that contributed the highest risk for suicide. More active prevention and treatment measures for depressive symptoms should be implemented in the cognitively impaired group.

OBJECTIVES: This study aimed to investigate the risk factors affecting suicidal ideation in community dwelling elderly individuals and to predict suicidal ideation through assessment tools.METHODS: We investigated 2,343 elderly individuals, aged 65 years or older, from February 2018 to December 2018. The participants were asked to complete sociodemographic questionnaires, including the Mini-Mental Status Examination for Dementia Screening(MMSE-DS), Short Geriatric Depression Scale(SGDS-K), Geriatric Anxiety Inventory(GAI), Athens Insomnia Scale(AIS), and Scales for Suicidal Ideation(SSI). We performed the Chi-squared test and logistic regression analysis for these data, to examine the relationship between suicidal ideation and the participants' risk factors. Moreover, we performed Receiver Operating Characteristics(ROC) curve analysis, to predict suicidal ideation through the assessment tools.RESULTS: The prevalence of suicidal ideation was 6.0%. Binary logistic regression revealed that cognitive impairment (OR=1.729, CI : 1.029–2.904), depression(OR=3.479, CI : 2.177–5.560), anxiety(OR=3.822, CI : 2.454–5.951), and sleeping disorders(OR=1.661, CI : 1.132–2.438) were independently associated with suicidal ideation. The cutoffs to predict suicidal ideation, obtained using ROC analysis were ≤21[area under the curve(AUC) : 0.582] for the MMSE-DS, >6(AUC : 0.822) for SGDS, >3(AUC : 0.817) for GAI, and >8(AUC : 0.718) for AIS.CONCLUSION: The incidence of suicidal ideation in the community dwelling elderly was quite high and was particularly related with depression and anxiety. These results could contribute to prevention and management of suicide among community dwelling elderly individuals.
Aged ; Anxiety ; Cognition Disorders ; Dementia ; Depression ; Humans ; Incidence ; Independent Living ; Logistic Models ; Prevalence ; Risk Assessment ; Risk Factors ; ROC Curve ; Sleep Initiation and Maintenance Disorders ; Suicidal Ideation ; Suicide ; Weights and Measures

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.
Advisory Committees ; Bias (Epidemiology) ; Carcinoma, Squamous Cell ; Counseling ; Expert Testimony ; Humans ; Mouth Neoplasms ; Neck ; Republic of Korea

BACKGROUND: The prevalence and incidence of Parkinson's disease (PD) are important for supporting the better comprehension of disease aspects and helping public health planning. Our aim is to evaluate the prevalence and incidence in South Korea between 2004 and 2013. METHODS: This retrospective, nationwide, longitudinal population-based study used National Health Insurance Service-National Sample Cohort Database to define patients with PD from 2004 to 2013 based on having Korean Classification of Diseases code G20, which were assigned by neurologists, and being prescribed PD medication. Annual prevalence and incidence were calculated. RESULTS: The prevalence of PD per 100,000 of population was 41.4 in 2004 and 142.5 in 2013, and there was 13.2% yearly increase over the 10 years. However, the incidence of PD per 100,000 of population increased steadily from 20.2 in 2004 to 53.1 in 2013. The prevalence and incidence were higher in women than in men. CONCLUSIONS: Our data show that there was an increasing trend in the prevalence and incidence of PD from 2004 to 2013, particularly in 70 years and older.
Classification ; Cohort Studies ; Comprehension ; Female ; Humans ; Incidence* ; Korea* ; Male ; National Health Programs ; Parkinson Disease* ; Prevalence* ; Public Health ; Retrospective Studies