OBJECTIVES: Previous studies have reported an association between circadian preference and personality. Defense mechanism is unconscious ego process which deals with an individual's anxiety and is closely associated with one's personality. Our aim is to investigate the association between defense mechanism and circadian preference in medical students. METHODS: One hundred forty eight medical students (70 males, 78 females), aged 22 to 30, answered the Beck Depression Inventory-II, Morningness-eveningness Questionnaire, and Korean version of Defense Style Questinnaire. RESULTS: Consumption (beta=-0.262, p=0.001) and being a male (beta=0.175, p=0.031) were significant positive predictors of eveningness, while sublimation (beta=0.185, p=0.023) was a significant negative predictor of eveningness. CONCLUSION: Our study showed a relationship between specific defense mechanisms (i.e., consumption and sublimation) and eveningness in medical students, but it did not address whether the relationship is a causal one.
Anxiety ; Defense Mechanisms ; Depression ; Ego ; Humans ; Male ; Surveys and Questionnaires ; Students, Medical* ; Sublimation*

PURPOSE: Rebamipide is a propionic acid derivative that inhibits superoxide production and removes hydroxyl radicals. This study was performed to investigate the effects of adding rebamipide to semen, in an effort to determine if reactive oxygen species (ROS) production and lipid peroxidation of the sperm cell membrane as well as an improvement in seminal parameter and fertilizing capacity under oxidative stress was inhibited. MATERIALS AND MTHODS: Semen was collected from 30 normal healthy volunteers by masturbation after at least 48 hours abstinence. After liquefaction of the semen at room temperature, the prepared sperm was diluted with a sperm wash media to a uniform density of 20x106/ml. The semen was treated with 0.25ml of 0.2mM FeSO4 and 1mM sodium ascorbate for 60 min in the presence of various rebamipide concentrations (0, 10, 30, 100, and 300microM). ROS production, sperm motility, vitality, fertilizing capacity and the level of lipid peroxidation were analyzed by chemiluminescence, computer assisted semen analysis, eosin-nigrosin staining, a hypo-osmotic swelling test and the thiobarbituric acid method, respectively. RESULTS: Rebamipide at 100 and 300microM increased the sperm motility (p<0.05) but did not affect the sperm vitality. The ROS production and lipid peroxidation in the sperms treated with FeSO4/sodium ascorbate were inhibited by rebamipide in a dose-dependent fashion (p<0.05 in each). The total swelling rate of the hypo-osmotic swelling test was also increased by high rebamipide concentrations (100 and 300microM), respectively 49.2 17.9 and 50.8 21.7% (p<0.05). CONCLUSIONS: These results suggest rebamipide is an effective free radical scavenger and may be useful as an oral antioxidant in patients with male infertility due to increased ROS generation. However, further study to be possible the clinical use of rebamipide for improve the fertilizing capacity in male infertility is required.
Antioxidants* ; Ascorbic Acid ; Cell Membrane ; Diethylpropion ; Healthy Volunteers ; Humans* ; Infertility, Male ; Lipid Peroxidation ; Luminescence ; Male ; Masturbation ; Oxidative Stress ; Reactive Oxygen Species ; Semen Analysis ; Semen* ; Sperm Motility ; Spermatozoa ; Superoxides

PURPOSE: Rebamipide is a propionic acid derivative that inhibits superoxide production and removes hydroxyl radicals. This study was performed to investigate the effects of adding rebamipide to semen, in an effort to determine if reactive oxygen species (ROS) production and lipid peroxidation of the sperm cell membrane as well as an improvement in seminal parameter and fertilizing capacity under oxidative stress was inhibited. MATERIALS AND MTHODS: Semen was collected from 30 normal healthy volunteers by masturbation after at least 48 hours abstinence. After liquefaction of the semen at room temperature, the prepared sperm was diluted with a sperm wash media to a uniform density of 20x106/ml. The semen was treated with 0.25ml of 0.2mM FeSO4 and 1mM sodium ascorbate for 60 min in the presence of various rebamipide concentrations (0, 10, 30, 100, and 300microM). ROS production, sperm motility, vitality, fertilizing capacity and the level of lipid peroxidation were analyzed by chemiluminescence, computer assisted semen analysis, eosin-nigrosin staining, a hypo-osmotic swelling test and the thiobarbituric acid method, respectively. RESULTS: Rebamipide at 100 and 300microM increased the sperm motility (p<0.05) but did not affect the sperm vitality. The ROS production and lipid peroxidation in the sperms treated with FeSO4/sodium ascorbate were inhibited by rebamipide in a dose-dependent fashion (p<0.05 in each). The total swelling rate of the hypo-osmotic swelling test was also increased by high rebamipide concentrations (100 and 300microM), respectively 49.2 17.9 and 50.8 21.7% (p<0.05). CONCLUSIONS: These results suggest rebamipide is an effective free radical scavenger and may be useful as an oral antioxidant in patients with male infertility due to increased ROS generation. However, further study to be possible the clinical use of rebamipide for improve the fertilizing capacity in male infertility is required.
Antioxidants* ; Ascorbic Acid ; Cell Membrane ; Diethylpropion ; Healthy Volunteers ; Humans* ; Infertility, Male ; Lipid Peroxidation ; Luminescence ; Male ; Masturbation ; Oxidative Stress ; Reactive Oxygen Species ; Semen Analysis ; Semen* ; Sperm Motility ; Spermatozoa ; Superoxides

OBJECTIVE: The purpose of this study was to examine the pharmacological treatment patterns in inpatients with bipolar disorder at a university hospital, and to establish appropriate clinical practice guideline in light of recent advances of pharmacotherapy of bipolar disorder. METHODS: A total of 454 first-admission cases with a diagnosis of bipolar disorder or schizoaffective disorder from 1990 to 2001 were analyzed with regard to the clinical characteristics and the use of mood stabilizers, antidepressants and antipsychotics. RESULTS: In manic, hypomanic, and mixed episodes, there has been a substantial increase in the use of valproate while the use of lithium has decreased. Antipsychotic drugs were prescribed as combination regimen in over 80% of total cases. In 44.6% of bipolar depression cases, mood stabilizers were not prescribed. In 70.7% of bipolar depression cases not receiving mood stabilizers, antidepressant monotherapy was utilized. The use of SSRIs and RIMA has increased, while a decrease was observed for TCA. There has been a tendency of the increased use of atypical antipsychotics. In particular, clozapine monotherapy has increased in mood stabilizer resistant cases. CONCLUSIONS: The results of the present study suggest that the prescription patterns have changed in general agreement with recent advances of pharmacotherapy of bipolar disorder during the past twelve years. However, there was clear tendency to use antipsychotics rather than other mood stabilizers as the combination regimen. Moreover, accurate diagnosis and careful reconsideration for pharmacological treatment strategies are required in bipolar depression, mixed states, and rapid cycling.
Antidepressive Agents ; Antipsychotic Agents ; Bipolar Disorder* ; Clozapine ; Diagnosis ; Drug Therapy* ; Humans ; Inpatients ; Lithium ; Prescriptions ; Psychotic Disorders ; Valproic Acid

OBJECTIVE: To analyze the clinical experiences of patients who treated with levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis associated with dysmenorrhea and/or menorrhagia. METHODS: The LNG-IUS was inserted into 103 patients who were diagnosed with adenomyosis on ultrasound examination and suffered from dysmenorrhea or menorrhagia at CHA Gangnam Medical Center between January 2009 and December 2009. Symptomatic changes of dysmenorrhea and menorrhagia, side effects, and failure rates were evaluated, retrospectively. RESULTS: During the follow-up periods, dysmenorrhea was improved in 91.4% and menorrhagia was improved in 90.4% of patients. Most common side effects were prolonged vaginal spotting in 41 (39.8%), and expulsion of LNG-IUS in 32 (31.1%) patients. Six (5.7%) patients were premature removal of LNG-IUS and 9 (8.5%) patients were underwent hysterectomy. Overall 77 (74.8%) patients continued to use of LNG-IUS. CONCLUSION: The LNG-IUS is effective treatment option for management of dysmenorrhea and menorrhagia for patients with clinical diagnosis of adenomyosis. It seemed to be an alternative treatment method before hysterectomy.
Adenomyosis ; Dysmenorrhea ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Menorrhagia ; Metrorrhagia

OBJECTIVE: To examine the therapeutic outcomes of methotrexate (MTX) in the treatment of unruptured interstitial pregnancy. METHODS: We reviewed the medical records of patients who were diagnosed with interstitial pregnancy and received MTX as first-line treatment between January 2003 and July 2014 at CHA Gangnam Medical Center. The treatment success rates and subsequent pregnancy outcomes were examined. RESULTS: Ninety-seven patients were diagnosed with interstitial pregnancy between January 2003 and July 2014. Of them, 38 initially received MTX treatment. The diagnosis was made at a median of 6+3 weeks (5+0 to 11+3 weeks). Thirty patients received a systemic MTX injection, while the other 8 received a local MTX injection. Systemic treatment composed of an 8-day alternating MTX regimen, single-dose regimen, or high-dose regimen (100 mg/m2 + 200 mg/m2 intravenously over 12 hours). The local injection consisted of a direct MTX injection into the gestational sac with or without systemic MTX injection. Twenty-one patients (55.3%) were successfully treated with MTX. However, MTX therapy failed in 17 patients (44.7%), who required surgery. Mode of MTX treatment was the only predictive variable of MTX treatment success (P=0.039). Treatment success was seen in 7 of 8 patients (87.5%) in the local MTX group vs. 14 of 30 patients (46.7%) in the systemic MTX group. After treatment, 13 patients attempted a successive pregnancy; of them, 10 patients had a confirmed clinical pregnancy and healthy live birth. CONCLUSION: Combined MTX treatment including a local injection might be an initial approach to the treatment of interstitial pregnancy.
Diagnosis ; Female ; Gestational Sac ; Humans ; Live Birth ; Medical Records ; Methotrexate* ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Pregnancy, Interstitial*

Ovarian stromal tumors containing Leydig cell components are rare. Only a few cases of ovarian stromal Leydig cell tumors characterized by clusters of Leydig cells have been reported to date. Here, we present the first case report of a 65-year-old woman with a cellular fibroma of the ovary containing Leydig cell hyperplasia. Microscopic examination revealed the proliferation of spindle cells arranged in intersecting bundles with mild nuclear atypia and an average of 2-3 mitotic figures per ten high-power fields. Multifocal nests of polygonal cells with abundant eosinophilic cytoplasm and round nuclei were seen within the spindle cells. Final pathology of the tumor revealed a cellular fibroma including Leydig cell hyperplasia.
Aged ; Cellular Structures ; Cytoplasm ; Eosinophils ; Female ; Fibroma ; Humans ; Hyperplasia ; Leydig Cell Tumor ; Leydig Cells ; Male ; Ovary

OBJECTIVE: To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). METHODS: We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility. The patients were treated with medroxyprogesterone acetate 500 mg/day and LNG-IUS. Treatment responses were evaluated every 3 months. EM aspiration biopsy was conducted after LNG-IUS removal followed D&C. The tissue samples were histologically compared. The diagnostic concordance rate of the two tests was examined with κ statistics. RESULTS: Twenty-eight pairs of EM samples were obtained from five patients. The diagnostic concordance rate of D&C and EM aspiration biopsy was 39.3% (κ value=0.26). Of the seven samples diagnosed as normal with D&C, three (42.8%) were diagnosed as normal by using EM aspiration biopsy. Of the eight samples diagnosed with endometrioid adenocarcinoma by using D&C, three (37.5%) were diagnosed with endometrioid adenocarcinoma by using EM aspiration biopsy. Of the 13 complex EM hyperplasia samples diagnosed with the D&C, five (38.5%) were diagnosed with EM hyperplasia by using EM aspiration biopsy. Of the samples obtained through EM aspiration, 46.4% were insufficient for histological evaluation. CONCLUSION: To evaluate the treatment responses of patients with early-stage EC treated with high dose oral progestin and LNG-IUS, D&C should be conducted after LNG-IUS removal.
Biopsy ; Biopsy, Needle* ; Carcinoma, Endometrioid ; Dilatation and Curettage* ; Dilatation* ; Endometrial Neoplasms* ; Female ; Fertility ; Gynecology ; Humans ; Hyperplasia ; Levonorgestrel* ; Medroxyprogesterone Acetate ; Observational Study ; Obstetrics ; Progesterone ; Prospective Studies

OBJECTIVE: To assess retrospectively the feasibility of intraoperative intraperitoneal (IP) chemotherapy with cisplatin in epithelial ovarian cancer. METHODS: IP chemotherapy during optimal staging surgery was performed in 10 patients who were diagnosed with primary epithelial ovarian cancers between April 2008 and February 2011. Cisplatin (70 mg/m2 in 1 L normal saline solution) was administered in the abdominal cavity for 24 hours postoperatively and then adjuvant chemotherapy was started 2-4 weeks after surgery. Perioperative toxicity of the combined treatment was evaluated until the initiation of postoperative adjuvant chemotherapy. RESULTS: A total of 23 adverse events were observed in 9 of 10 patients (grade 1, 7; grade 2, 13; grade 3, 3; grade 4, 0). In descending order of frequency, adverse events affected the gastrointestinal system (n=14), hematologic system (n=6), pulmonary system (n=2), and genito-urinary system (n=1). The adverse events did not affect adjuvant systemic chemotherapy schedules. One patient experienced disease recurrence in the liver 16 months after surgery. The remaining 9 patients have been well controlled by chemotherapy and/or observation during the follow-up period of 4 to 39 months after surgery. CONCLUSION: Intraoperative IP chemotherapy with cisplatin during surgical procedures is considered feasible for the treatment of primary epithelial ovarian cancer. Further studies, including long-term, prospective and comparative trials, are needed to validate the efficacy of this combined therapy.
Abdominal Cavity ; Appointments and Schedules ; Chemotherapy, Adjuvant ; Cisplatin ; Follow-Up Studies ; Humans ; Liver ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Recurrence ; Retrospective Studies

OBJECTIVE: The aim of the present study was to evaluate the impact of previous abdominal surgery on surgical outcomes of single-port access (SPA) total laparoscopic hysterectomy (TLH). METHODS: We reviewed the medical records of 111 women who underwent SPA-TLH at the Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University between January 2010 and December 2010. Women were classified according to their history of previous abdominal surgery. RESULTS: Of 111 women undergoing SPA-TLH, 74 women (66.7%) without history of previous abdominal surgery and 37 women (33.3%) with history of previous abdominal surgery were classified. There was no significant difference in surgical outcomes including operative time, estimated blood loss, change in hemoglobin, uterine weight, perioperative complications, transfusion, and additional port insertion between two groups. CONCLUSION: In our experience, previous abdominal surgery has no significant impact on SPA-TLH.
Female ; Gynecology ; Hemoglobins ; Humans ; Hysterectomy ; Laparoscopy ; Medical Records ; Obstetrics ; Operative Time