Military Manpower Administration

To examine the clinical features and long-term surgical results of highly myopic full-thickness macular hole (FTMH) without retinoschisis. We retrospectively assessed surgical outcomes of highly myopic patients who underwent vitrectomy with internal limiting membrane peeling and gas tamponade to treat FTMH without retinoschisis. Post-operative examinations were conducted at 1, 3, 6, and 12 months after surgery, with further follow-up intervals adjusted based on physician's discretion. Clinical features related to visual acuity and anatomical success, defined as hole closure without developing foveal atrophy, were assessed. Thirty-three eyes (30 patients) were included, and the mean follow-up period was 61.1 ± 48.8 months. Macular hole closure was achieved in 31 (93.9%) eyes, of which 16 (51.6%) developed foveal atrophy during follow-up. Eyes with anatomical success exhibited a significant better visual prognosis than those without during whole follow-up period (P ≤ 0.031), showing a significant postoperative visual improvement from baseline at 6 months, 12 months and final visit (P = 0.002, P < 0.001 and P = 0.013, respectively). Greater minimal macular hole diameter (P = 0.002) and the presence of posterior staphyloma (P = 0.040) were significantly related to anatomical failure, whereas longer axial length was significantly related to poorer final best-corrected visual acuity (P < 0.001). Hole closure rate after vitrectomy in highly myopic patients with FTMH without retinoschisis was high. However, the postoperative development of foveal atrophy hindered vision improvement. Posterior staphyloma, greater minimal hole diameter, and longer axial length were predictive of poor prognosis.

Over the past two decades, interest in minimally invasive scoliosis surgery (MISS) for adolescent idiopathic scoliosis (AIS) has grown substantially, driven by advancements in growth-based surgical techniques. Given the substantial advancements in MISS for AIS, investigating the bibliometric data of the scientific literature is crucial to understanding the current research trend and providing valuable insights into its future directions. However, limited information on MISS for AIS exists in the literature. The publication data related to MISS for AIS from 2004 to 2024 were exported from the Web of Science. The research output between 2004 and 2024 was 373 for publication volume, 7760 for citations, and 46 for h-index. The annual publication and citation trend over time showed a gradual increase with fluctuations up until 2017, followed by a sharp upward trend starting in 2018. The foremost countries and affiliations in this field were the United States and Montreal University in Canada, respectively. The top 10 most-cited articles on MISS in AIS predominantly focused on the topic of vertebral body tethering (VBT). Among the productive authors, most contributions were focused on VBT, while several authors in South Korea significantly contributed to the study of MISS via a posterior approach. Historical development of VBT and posterior MISS identified their current advantages and limitations and highlighted potential future research directions.

BackgroundLumbar facet synovial cysts (LFSCs) are an uncommon degenerative lesion in the lumbar spine, but treatment remains controversial. We report two rare cases of spontaneous regression of large-sized LFSCs.Case presentationA 68-year-old male visited our outpatient clinic with a complaint of lower back pain and right lower extremity radiculopathy beginning approximately two weeks prior. Computed tomography of the spine showed facet arthrosis, and magnetic resonance imaging (MRI) of the spine revealed a large, oval cystic-mass-like lesion at the L5–S1 level. After conservative treatment for one year, the patient’s symptoms had completely resolved, and a follow-up MRI showed spontaneous regression of the large LFSC. A 69-year-old female with a complaint of radiating pain on left lower extremity and intermittent claudication that had aggravated about 2 months ago also showed a 1.5 × 1.2 × 1.7 cm oval cystic mass involving left L5, S1 nerve roots at L5–S1 level from the MRI. After conservative treatment for three months, a follow-up MRI also showed spontaneous resolution of the large LFSC.ConclusionsThe large-sized LFSCs spontaneously regressed without any surgical intervention. If symptoms can be controlled, conservative treatment should be considered for first-line treatment despite a mismatch between radiological and clinical findings. Careful clinical judgments are essential to prevent unnecessary surgery.

Background/Objectives: Current studies on adverse events related to the COVID-19 vaccine have predominantly focused on severe, life-threatening side effects. However, numerous less severe but common adverse events (AEs) remain underreported and insufficiently investigated despite their potential impact. Methods: This population-based cohort study investigated the cumulative incidence rate (cIR) and risk of the broad-spectrum AEs of special interests (AESIs) based on immune response, including gynecological, dermatological, ophthalmological, otologic, and dental problems, following COVID-19 vaccination. Results: Among 4,203,887 individuals in Seoul, South Korea, the final analysis included 1,458,557 vaccinated subjects and 289,579 non-vaccinated subjects after the exclusion of underlying diseases. The cIR of AESIs for three months was significantly higher in vaccinated subjects than in non-vaccinated subjects, except for endometriosis. The vaccination significantly increased the risks of all the AESIs except for visual impairment. The risk of alopecia showed the highest HRs (HR [95% CI] = 2.40 [1.90-3.03]) among the AESIs following COVID-19 vaccination. Among the vaccinated subjects, heterologous vaccination was associated with the increased risk of most of the AESIs. Conclusions: Our findings suggest that clinicians should closely recognize and follow up on various COVID-19 vaccine-related AEs due to their unknown impact, even if they may not be serious at present.

The purpose of this study was to identify the attitude of South Korean medical school students towards psychiatry and to analyze how lectures and clinical clerkship in psychiatry effect changes in students' attitudes. A total of 100 medical school students were recruited as subjects in the study, 86 of whom completed psychiatry lectures and underwent psychiatry clerkship from March 2015 to August 2018. The participating students completed a survey, which included demographic data, specialty choice, and attitude towards psychiatry. Subjects who completed lectures and clinical clerkship in psychiatry showed positive changes in attitude towards psychiatry in the following items: "Among mental health professionals, psychiatrists have the most authority and influence" (p=0.002), "Psychiatrists frequently abuse their legal power to hospitalize patients against their will" (p<0.001), and "Many people who could not obtain a residency position in other specialties eventually enter psychiatry" (p=0.028). However, negative changes in attitude towards psychiatry were shown in the following item: "On average, psychiatrists make as much money as most other doctors" (p=0.008). Also, specific medical school factors scored positively overall. Although it was not statistically significant, the questionnaire item "During my psychiatry rotation, psychiatry residents were good role models" was more positively observed by students after completion of psychiatry lectures and clerkship. After each curriculum, certain attitudes toward psychiatry were positively changed, but others either remained unchanged or were negatively changed. By using these study results to revise the current curriculum, medical school students' attitude towards psychiatry can be improved.

Abstract BackgroundThe purpose of this study was to identify the attitude of South Korean medical school students towards psychiatry and to analyze how lectures and clinical clerkship in psychiatry effect changes in students’ attitudes. MethodsA total of 100 medical school students were recruited as subjects in the study, 86 of whom completed psychiatry lectures and underwent psychiatry clerkship from March 2015 to August 2018. The participating students completed a survey, which included demographic data, specialty choice, and attitude towards psychiatry. ResultsSubjects who completed lectures and clinical clerkship in psychiatry showed positive changes in attitude towards psychiatry in the following items: “Among mental health professionals, psychiatrists have the most authority and influence” (p=0.002), “Psychiatrists frequently abuse their legal power to hospitalize patients against their will” (p&lt;0.001), and “Many people who could not obtain a residency position in other specialties eventually enter psychiatry” (p=0.028). However, negative changes in attitude towards psychiatry were shown in the following item: “On average, psychiatrists make as much money as most other doctors” (p=0.008). Also, specific medical school factors scored positively overall. Although it was not statistically significant, the questionnaire item “During my psychiatry rotation, psychiatry residents were good role models” was more positively observed by students after completion of psychiatry lectures and clerkship. ConclusionAfter each curriculum, certain attitudes toward psychiatry were positively changed, but others either remained unchanged or were negatively changed. By using these study results to revise the current curriculum, medical school students’ attitude towards psychiatry can be improved.

The clinical and radiologic outcomes of symptomatic adult moyamoya disease (MMD) patients who have an occluded anastomosis immediately after bypass surgery are poorly studied. The clinical and angiographic outcomes of non-patent anastomosis in symptomatic adult MMD patients were retrospectively reviewed. From August 2011 to November 2016, 31 revascularization surgeries, consisting of direct and indirect bypass, were performed on 29 adult MMD patients. Primary outcomes were evaluated based on the frequency of transient ischaemic attack (TIA) incidence and the recurrence of cerebral infarction and were assessed as improvement or worsening. Among 31 cases, computed tomography angiography (CTA) on the first day after surgery showed patent anastomosis in 20 hemispheres and non-patent anastomosis in 11 hemispheres. Follow-up conventional angiographies showed spontaneous recanalization of non-patent anastomosis in all occlusion cases. The incidence of TIA decreased in both the non-patent and the patent groups. Two newly developed cerebral infarctions were observed, which occurred in the patent group. Patients in the non-patent group also showed clinical improvement after surgery (p = 0.04), and no significant relationship was found between immediate postoperative patency and the primary outcome (p = 0.53). In our series, regardless of patency immediately after bypass surgery, delayed recanalization and clinical improvement can be expected after bypass surgery for adult MMD.

PurposeThis study was to determine the prevalence of herniated intervertebral disc (HIVD) among Korean 19-year-old male in a large national sample and to compare the prevalence across geographic regions based on the data of conscription.Materials and MethodsWe analyzed the conscription data of 615508 cases who were 19-year-old male, given an examination for conscription at nationwide Korean Military Manpower Administration from January 2008 to December 2009. Prevalence was determined by dividing the number of cases by the number of persons enrolled for 2 years. The analyses included of a cross-tabulations and nonparametric chi-square to compare the prevalence according to geographic region, disc severity, and conscription year.ResultsThe prevalence of HIVD among 19-year-old male was 0.47%. Seoul had the highest prevalence of HIVD (total HIVD was 0.60%, and severe HIVD was 0.44%). The prevalence of HIVD was lower in Jeollabuk-do and Jeollanam-do (total HIVD was 0.25-0.27%, and severe HIVD was 0.16-0.17%). Annual prevalence of HIVD was slightly decreased in 2009, but geographic distribution annually was not different.ConclusionIn Korean 19-year-old male, the national prevalence of adolescent HIVD was 0.60%, but different geographic distribution was observed. It is quite possible that secondary contributing factor(s) interfere with the different geographic prevalence of HIVD.