OBJECTIVES: To investigate the frequency and clinical characteristics of premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD) in high school students, and determine the correlates of PMS/PMDD in association with comorbid depression and anxiety. METHODS: A total of 1688 students were recruited from 5 high schools in Seoul, Korea. Subjects completed the questionnaire composed of scales to measure premenstrual symptoms, depression, and anxiety, as well as sociodemographic and reproductive variables. Subjects were categorized into 3 groups by using the Premenstrual Symptom Screening Tool(PSST) to determine the frequency and clinical characteristics of PMS/PMDD. Multivariate logistic regression was used to identify the correlates of PMS/PMDD. RESULTS: The frequency of moderate to severe PMS and PMDD was 20.1% and 6.4%, respectively. Irritability (78.8%), fatigue(76.4%), and emotional sensitivity(69.8%) were common premenstrual symptoms, and functional impairment in academic performance(67.1%) was dominant. Dysmenorrhea[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], family history of PMS(OR=1.91, 95% CI 1.35-2.71), and use of oral contraceptive (OR=1.85, 95% CI 1.16-2.94) were associated with the increased risk of PMS/PMDD after adjustment for depression and anxiety. Negative attitude to menses(OR=15.60, 95% CI 3.61-67.42) was associated with the increased risk of PMS/PMDD, particularly in subjects without depression and anxiety. CONCLUSIONS: PMS was common, as the frequency of PMS more than moderate severity including PMDD exceeded 25%, and disrupted daily functioning in adolescents. PMS is associated with various sociodemographic and menstrual characteristics, and these associations are affected by comorbid depression and anxiety.
Adolescent ; Anxiety ; Depression ; Humans ; Korea ; Logistic Models ; Mass Screening ; Premenstrual Syndrome ; Questionnaires ; Weights and Measures

PURPOSE: Allelic loss on chromosome 18q is a hallmark of presence of a tummor represser gene. Recently, DPC4 (deleted in pancreatic carcinoma, locus 4), a candidate tumor suppressor gene, has been localized at 18q21. Inactivation of DPC4 gene was reported in pancreatic carcinomas, coloretal carcinomas, and prostatic carcinomas. The aim of the present study was to determine if it might be altered in stomach cancer. MATERIALS AND METHODS: We tested for DPC4 gene mutations and allelic status at 18q21 using a modified 'cold SSCP' method in 48 primary gastric carcinoma and correlated the findings with various clinicopathologic characteristics of the patients. RESULTS: The frequency of mutations in primary gastric cancer was 27.1% (13/48). Mutations of exon 1, 8, 10 were found in 2 (4.1%), 4 (8.2%) and 7 cases (14.6%), respectively. DNA sequencing of 13 cases with DPC4 mutations identified six cases (46.1%) with substitution, four cases with deletion (30.7%), and two cases (23.1%) with insertion. No significant difference was observed in the frequency of DPC4 mutations in terms of other various clinicopathologic characteristics. CONCLUSION: These findings suggest that DPC4 mutations may play a significant role in the establishment and progression of the primary gastric cancer.
Exons ; Genes, Tumor Suppressor ; Humans* ; Loss of Heterozygosity ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Stomach Neoplasms* ; Stomach*

Objective To evaluate the preliminary outcome of postoperative three-dimensional conformal radiation therapy(3DCRT)as compared with conventional radiation therapy(CRT)in stageⅢA non-small cell lung cancer(NSCLC).Methods From December 1994 to February 2002,114 such patients received postoperative radiotherapy in M.D.Anderson Cancer Center,with 63 patients in CRT group and 51 in 3DCRT group.The median radiation dose was 53.5 Gy/27f/5-6w and 52.8 Gy/26f/5-6w in CRT and 3DCRT group, respectively.Results The median follow-up time was 28 and 13 months in CRT and 3DCRT group.The 1-,2- year overaLl survival were 80%,62% and 93%,70%.The 1-,2-year disease free survival was 62%,44% and 58%,32% in CRT group and in 3DCRT group,respectively.There was no significant difference between CRT group and 3DCRT group in terms of overall survival,disease-free survival,local-regional control,distant metastasis-free survival or treatment-related complication.There was significant difference in the death cause between two group,with 4 patients having died of cardiac complication in the CRT group and none in the 3DCRT group.Conclusions Postoperative three-dimensional conformal radiotherapy can reach the same immediate results of conventional radiotherapy in stageⅢA NSCLC,with a lower incidence of cardiac complication. However,the long-term results need further follow-up.

OBJECTIVES: We aimed to explore the relationship among fatigue and perceived stress, depressive mood in the working population. We also examined associations with demographic and life style factors and investigated the effect of individual coping skills on these associations. METHODS: Fatigue Severity Scale(FSS), Perceived Stress Scale(PSS), Brief Encounter Psychosocial Instrument - Korean version(BEPSI-K), Beck Depression Inventory(BDI), Stress Coping Skill Questionnaire were administered to 621 civil servants. All of above and other demographic factors are self-administered questionnaire survey and this study is cross sectional. RESULTS: Mean FSS score was 3.04 which was lower than 3.22, the severity cut off score. FSS, PSS, BEPSI-K, BDI were all higher in female. Subjects with active coping skills showed relatively low fatigue, perceived stress, depressive mood than those with passive coping skills. Logistic regression analyses indicated that the PSS, BDI, BEPSI-K in working population increase the risk of fatigue and regular exercise lowers the risk. CONCLUSIONS: Adults who were afflicted by stress, experienced depressive mood or were physically inactive were at much higher risk of feeling fatigue. Since no other large data sets are available for fatigue, the results from this study could serve a very useful purpose, to furnish a basis for comparison with future research results based on more complete data.
Adaptation, Psychological ; Adult ; Dataset ; Demography ; Depression ; Fatigue* ; Female ; Humans ; Life Style ; Logistic Models ; Questionnaires

Ninety-two strains of Serratia marcescens isolated from 5 hospitals were analyzed for plasmid profile, antimicrobial drug resistance pattern, biotyping, and production of pigment. Ninety-three percents of strains were resistant to chloramphenicol (Cm), tetracycline (Tc), sulfisoxazole (Su), cefazolin (Cz), ampicillin (Ap), and rifampin (Rf). A majority of strains were susceptible to amikacin (Ak), ciprofloxacin (Ci), and cefotaxim (Ct). Fifty-four resistance patterns were found in 94 strains and the most prevalent resistance pattern was CmTcSuApCzRf. Seventeen (17.4%) isolates could transfer their partial resistance to E. coli or Klebsiella pneumoniae by conjugation. Twenty-seven plasmid profiles in 54 strains (58.7%) were detected, however no predominant patterns were seen in isolates from each hospital. Eleven biotypes were detected. The common types were A3b (29.4%) and A8b (27.1%), predominant types were found in each hospital. Twenty strains from 4 of 5 hospitals showed consistence of 3 types. These results indicate that plasmid profile analysis, Grimont biotyping, and resistance pattern type of strains in combination are useful as an epidemiological tool for S. marcescens isolates and some of isolates were confirmed as nosocomial strains.
Amikacin ; Ampicillin ; Cefazolin ; Cefotaxime ; Chloramphenicol ; Ciprofloxacin ; Drug Resistance, Microbial ; Epidemiologic Studies* ; Klebsiella pneumoniae ; Plasmids ; Rifampin ; Serratia marcescens* ; Serratia* ; Sulfisoxazole ; Tetracycline

Radiation dose escalation and acceleration improves local control but also increases toxicity. Proton radiation is an emerging therapy for localized cancers that is being sought with increasing frequency by patients. Compared with photon therapy, proton therapy spares more critical structures due to its unique physics. The physical properties of a proton beam make it ideal for clinical applications. By modulating the Bragg peak of protons in energy and time, a conformal radiation dose with or without intensity modulation can be delivered to the target while sparing the surrounding normal tissues. Thus, proton therapy is ideal when organ preservation is a priority. However, protons are more sensitive to organ motion and anatomy changes compared with photons. In this article, we review practical issues of proton therapy, describe its image-guided treatment planning and delivery, discuss clinical outcome for cancer patients, and suggest challenges and the future development of proton therapy.
Carcinoma, Hepatocellular ; radiotherapy ; Female ; Four-Dimensional Computed Tomography ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Liver Neoplasms ; radiotherapy ; Lung Neoplasms ; radiotherapy ; Male ; Neoplasms ; radiotherapy ; Photons ; therapeutic use ; Prostatic Neoplasms ; radiotherapy ; Protons ; therapeutic use ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Uterine Cervical Neoplasms ; radiotherapy

OBJECTIVES: The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. METHODS: Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. RESULTS: The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. CONCLUSIONS: This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.
Anxiety ; Anxiety Disorders ; Brain Injuries ; Delirium, Dementia, Amnestic, Cognitive Disorders ; Depression ; Epidemiologic Studies ; Gyeonggi-do ; Humans ; International Classification of Diseases ; Mood Disorders ; Personality Disorders ; Questionnaires* ; Reproducibility of Results

For the use of Indirect-conversion CMOS (complementary metal-oxide-semiconductor) detectors for digital x-ray radiography and their better designs, we have theoretically evaluated the spatial-frequency-dependent detective quantum efficiency (DQE) using the cascaded linear-systems transfer theory. In order to validate the developed model, the DQE was experimentally determined by the measured modulation-transfer function (MTF) and noise-power spectrum, and the estimated incident x-ray fluence under the mammography beam quality of W/Al. From the comparison between the theoretical and experimental DQEs, the overall tendencies were well agreed. Based on the developed model, we have investigated the DQEs values with respect to various design parameters of the CMOS x-ray detector such as phosphor quantum efficiency, Swank noise, photodiode quantum efficiency and the MTF of various scintillator screens. This theoretical approach is very useful tool for the understanding of the developed imaging systems as well as helpful for the better design or optimization for new development.
Mammography ; Noise ; Radiographic Image Enhancement

OBJECTIVES: The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. METHODS: We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. RESULTS: 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory≥16), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. CONCLUSIONS: Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.
Anxiety ; Cross-Sectional Studies ; Depression* ; Female ; Health Behavior ; Health Promotion ; Humans ; Menopause ; Prevalence ; Prospective Studies ; Psychology ; Quality of Life* ; World Health Organization

The authors operated 17 cases out of 28 intracranial arachnoid cysts experienced from July, 1972 to August, 1981. The clinical analysis and surgical experiences were summarized as follows. The supratentorial cysts were 67.9% and the infratentorial cysts were 32.1% of the intracranial arachnoid cysts. The predilection sites were middle cranial fossa of the supratentorial(60.7%) and the inferior midline of the infratentorial(17.9%). 2) The middle fossa arachnoid cysts were prominent in males under the age of 20. 3) The common complicating lesions in the supratentorial arachnoid cysts were chronic subdural hematoma(23.5%) and subdural hygroma(5.9%). Hydrocephalus was usually combined with the infratentorial arachnoid cyst(66.7%). 4) The most frequent symptom was headache(75%) with similar frequency in both supratentorial and infratentorial lesions. In the supratentorial cysts, headache was also complained with highest frequency even in cases without increased intracranial pressure(61.5%). The main clinical features of arachnoid cysts were headache, signs of increased intracranial pressure, other neurologic deficits and seizure in order of frequency. 5) Cranial deformities on the plain X-ray films were observed in 70.6% of middle fossa cysts. The brain CT scan provided a definite diagnostic information, while the cerebral angiography offered clues for differential diagnosis. 6) The authors selected the direct intracranial approach as a curative measure in most cases and the essential step in this procedure was thought to establish a communication between the cyst and the basal cistern or adjacent subarachnoid space. But in a few special cases such as deep-seated cysts or extensively large ones, a cystoperitoneal shunt was a more preferable procedure. The infratentorial cysts with hydrocephalus almost always required ventriculoperitoneal shunt in our cases. We considered it is very important to perform periodic follow-up brain CT scan to detect a recurrence of cyst or recollection of C.S.F., postoperative complications and persistent hydrocephalus.
Arachnoid ; Arachnoid Cysts* ; Brain ; Cerebral Angiography ; Congenital Abnormalities ; Cranial Fossa, Middle ; Diagnosis, Differential ; Headache ; Humans ; Hydrocephalus ; Intracranial Pressure ; Male ; Neurologic Manifestations ; Postoperative Complications ; Recurrence ; Seizures ; Subarachnoid Space ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt ; X-Ray Film